| Regimental number | 2362 |
| Place of birth | Coolgardie Western Australia |
| Religion | Church of England |
| Occupation | Stockman |
| Address | Coolgardie PO, Coolgardie, Western Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs Anna Jacobsen, Silvester Street, Cooolgardie, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 16th Reinforcement |
| AWM Embarkation Roll number | 10/15/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A52 Surada on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Anzac Battalion, Imperial Camel Brigade |
| Fate | Returned to Australia |
| Other details |
War service: Middle East Medals: British War Medal, Victory Medal |
| Date of death | |
| Place of burial | Karrakatta Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
