| Regimental number | 6026 |
| Place of birth | West Kentish Tasmania |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Claude Road, Sheffield, Tasmania |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs C W Jackson, Claude Road, Sheffield, Tasmania |
| Enlistment date | 1 April 1916 |
| Date of enlistment from Nominal Roll | 1 May 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/22/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on 28 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Battalion |
| Fate | Returned to Australia 21 December 1917 |
