| Regimental number | 7784 |
| Place of birth | Maryborough Victoria |
| Religion | Church of England |
| Occupation | Gardener |
| Address | Belmont, Western Australia |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Mother, Mrs Louisa Jackson, Belmont Avenue, Belmont, Western Australia |
| Enlistment date | 18 May 1917 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 26th Reinforcement |
| AWM Embarkation Roll number | 23/33/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 1 August 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Effective abroad (still overseas) |
