| Regimental number | 1369 |
| Place of birth | Orange New South Wales |
| Religion | Roman Catholic |
| Occupation | Cook |
| Address | Undercliffe Road, via Marrickville, New South Wales |
| Marital status | Single |
| Age at embarkation | 44 |
| Next of kin | Father, Thomas Jacobs, Undercliffe Road, via Marrickville, New South Wales |
| Enlistment date | 27 November 1914 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 2nd Reinforcement |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A48 Seang Bee on 11 February 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Battalion |
| Fate | Returned to Australia 28 April 1915 |
