| Regimental number | 5931 |
| Place of birth | Mount Gambia South Australia |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Kingston via Mount Gambier, South Australia |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Margaret Jacobsen, Kingston via Mount Gambier, South Australia |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Light Horse Brigade Train 4 |
| AWM Embarkation Roll number | 25/102/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A19 Afric on |
| Regimental number from Nominal Roll | 8893 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 14th Company, Australian Army Service Corps |
| Fate | Returned to Australia |
| Other details |
Medals: 1914-15 Star, British War Medal, Victory Medal |
| Date of death | |
| Age at death | 64 |
| Place of burial | AIF Cemetery (Row 19, Grave No. 53), West Terrace, Adelaide, South Australia |