| Regimental number | 2922 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Bootmaker |
| Address | York Street, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, Robert Jacobsen, York Street, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 54th Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/71/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A11 Ascanius on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 56th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
