| Regimental number | 3858 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Woy Woy, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Father, A Jacobson, Woy Woy, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A54 Runic on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
