| Regimental number | 2191 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Driver |
| Address | Kew PO, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Brother, Norman Jackson, PO, Adelaide, South Australia |
| Enlistment date | 12 March 1915 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/23/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A62 Wandilla on 17 June 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Returned to Australia 29 August 1915 |
