| Regimental number | 4229 |
| Place of birth | Durham England |
| Religion | Methodist |
| Occupation | Farm hand |
| Address | C/o Post Office, Katanning, Western Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Father, Mr H Jackson, 57 Deane Road, South Shields, England |
| Enlistment date | 24 September 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A30 Borda on 17 January 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 3 March 1919 |
