| Regimental number | 61658 |
| Occupation | Plumber |
| Next of kin | Father, C Jacobson, c/o F Balchin, Woodville |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 33rd Reinforcements, Wellington Infantry Regiment, B Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT No 99 Athenic on |
| Sources | Nominal Roll Vol. 3: Roll 76, p. 8 |