| Regimental number | 1 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Moray Street, New Farm, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, W S Jacob, 'Borrodeile', Moray Street, New Farm, Brisbane, Queensland |
| Enlistment date | |
| Rank on enlistment | Lance Corporal |
| Unit name | 3rd Field Ambulance, A Squadron |
| AWM Embarkation Roll number | 26/46/1 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board Transport A22 Rangatira on |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
