| Regimental number | 3041 |
| Place of birth | Glenelg South Australia |
| Religion | CS |
| Occupation | Student |
| Address | East Terrace, Kensington Gardens, Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs F E Jacob, East Terrace, Kensington Gardens, Adelaide, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/27/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on |
| Regimental number from Nominal Roll | Commissioned |
| Rank from Nominal Roll | 2nd Lieutenant |
| Unit from Nominal Roll | 10th Battalion |
| Recommendations (Medals and Awards) |
Military Medal 'Conspicuous bravery and devotion to duty at Pozieres.' Recommendation date: |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 184 Date: |