| Regimental number | 6755 |
| Place of birth | Kempton Tasmania |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bridgewater, Tasmania |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs E G Jacques, North Bridgewater, Tasmania |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/29/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A56 Palermo on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
