| Regimental number | 5583 |
| Religion | Presbyterian |
| Occupation | Driver |
| Address | 70 John Street, East Brunswick, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, J J Jansen, 70 John Street, East Brunswick, Victoria |
| Previous military service | 30th AASC |
| Enlistment date | 16 July 1915 |
| Date of enlistment from Nominal Roll | 20 July 1915 |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 2, Reinforcement 11 |
| AWM Embarkation Roll number | 13/30/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 11 October 1915 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 1st AVC |
| Fate | Returned to Australia 27 April 1919 |
