| Regimental number | 7079 |
| Place of birth | Lancashire England |
| Religion | Church of England |
| Occupation | Blacksmith's striker |
| Address | Cottesloe Beach, Western Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, Tom Jefferson, Black Boy, Hill Camp, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/45/4 |
| Embarkation details | Unit embarked from Albany, Western Australia, on board HMAT A16 Port Melbourne on |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Field Company Engineers |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
