| Regimental number | 21965 |
| Place of birth | West Melbourne Victoria |
| Religion | Church of England |
| Occupation | Bootmaker |
| Address | 58 Jeffcott Street, West Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs M J Jacobson, 58 Jeffcott Street, West Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Howitzer Brigade 23, Battery 107 |
| AWM Embarkation Roll number | 13/133/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A7 Medic on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 7th Field Artillery Brigade |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |