| Regimental number | 21796 |
| Place of birth | Newcastle New South Wales |
| Religion | Church of England |
| Occupation | Motor mechanic |
| Address | Woy Woy, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, A. Jacobsen, same address |
| Enlistment date | |
| Rank on enlistment | Sapper |
| Unit name | Engineering Field Companies, General Reinforcements |
| AWM Embarkation Roll number | 14/42/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A54 Runic on |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 11th Field Company Engineers |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
