| Regimental number | 4165 |
| Place of birth | Maryborough Queensland |
| Religion | Baptist |
| Occupation | Butcher |
| Address | Austin Street, Rosehill, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs A Costin, Austin Street, Rosehill, Sydney, New South Wales |
| Enlistment date | 9 August 1915 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A60 Aeneas on 20 December 1915 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 2nd DMTCoy |
| Fate | Returned to Australia 11 May 1919 |