| Regimental number | 5703 |
| Place of birth | Coolah New South Wales |
| Religion | Church of England |
| Occupation | Miner |
| Address | Bakery, Coolah, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, H Jackson, Bakery, Coolah, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A46 Clan Macgillivray on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |
| Date of death | |
| Place of burial | Rookwood Crematorium |