| Regimental number | 4200 |
| Place of birth | Isle Of Wight England |
| Religion | Church of England |
| Occupation | Driver |
| Address | The Lodge, Strathspey Mitcham, South Australia |
| Marital status | Married |
| Age at embarkation | 22 |
| Next of kin | Wife, Mrs C M Jacobs, The Lodge, Strathspey Mitcham, South Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 11th Field Artillery Brigade |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
