| Regimental number | 3166 |
| Place of birth | Alpha Queensland |
| Religion | Church of England |
| Occupation | Drover |
| Address | Clermont, Queensland |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, Richard Owen Jansan, Clermont, Queensland |
| Enlistment date | 3 November 1916 |
| Rank on enlistment | Private |
| Unit name | 41st Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/58/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 7 February 1917 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 41st Battalion |
| Fate | Returned to Australia 7 July 1919 |
