| Regimental number | 3995 |
| Place of birth | Sale Victoria |
| Religion | Church of England |
| Occupation | Station hand |
| Address | 3 Park Street, North Williamstown, Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Mother, Mrs Charlotte Jackson, 3 Park Street, North Williamstown, Melbourne, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 24th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/41/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A69 Warilda on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 24th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
