| Regimental number | 3264 |
| Place of birth | Broken Hill New South Wales |
| Religion | Roman Catholic |
| Occupation | Farm hand |
| Address | c/o Central Hotel, Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs M Jackson, North Dandalup, Western Australia |
| Enlistment date | 13 August 1915 |
| Date of enlistment from Nominal Roll | 31 July 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/28/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A38 Ulysses on 2 November 1915 |
| Regimental number from Nominal Roll | 3254 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Employment Company |
| Fate | Returned to Australia 21 December 1918 |
