| Regimental number | 1960 |
| Place of birth | Bunbury Western Australia |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Coonabarabran, New South Wales |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs Mary Ann Costin, Bunbury PO, Bunbury, Western Australia |
| Enlistment date | 1 February 1916 |
| Rank on enlistment | Private |
| Unit name | 33rd Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/50/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Port Sydney on 4 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 33rd Battalion |
| Fate | Returned to Australia 7 June 1919 |