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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800068

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Grace Chesley ChandlerBuck Sex Female

Date of Birth October 29, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Chesley Demill Buck MAIDEN NAME of Mother Isabel Jardine

Residence of Father when child was born Sydney Present address of Father Sydney

Occupation of Father at Birth of child Salesman Place of birth of Father Dorchester, New Brunswick

Race British Name and present address of Physician in attendance at birth Dr. Owen Cameron, Antigonish

Signature of Applicant Chesley DeMill Buck Address of Applicant Sydney Date May 11, 1944

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Grace Chesley ChandlerBuck

Born at Sydney in the County of Cape Breton

That Grace Chesley ChandlerBuck Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 29, 1920

My knowledge of the fact and date of such Birth is based on the following Circumstances:

I am the father of the said Grace Chesley Chandler Buck and I was in Sydney at the time of the birth and am fully [?] with the fate of her birth

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