| Regimental number | 4741 |
| Place of birth | Charters Towers Queensland |
| Religion | Methodist |
| Occupation | Lbourer |
| Address | Marion Street, Charters Towers, Queensland |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Elizabeth Jackson, Marion Street, Charters Towers, Queensland |
| Enlistment date | 5 November 1915 |
| Rank on enlistment | Private |
| Unit name | 26th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/43/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on 12 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 26th Battalion |
| Fate | Returned to Australia 30 January 1918 |
