| Regimental number | 1121 |
| Religion | Church of England |
| Occupation | Upholsterer |
| Address | Townsville, Queensland |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, A E Da Costa, 23 Great Thorn Street, Edgecliffe, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 1st Reinforcement |
| AWM Embarkation Roll number | 23/18/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on |
| Rank from Nominal Roll | Private |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
