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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000114

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Francis PatrickPeck Sex Male

Date of Birth July 19, 1920 Place of Birth LouisburgCounty of Cape Breton

Name of Father Thomas Bernard Peck MAIDEN NAME of Mother Frances Lamont

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Louisburg, Cape Breton Co. Present address of Father Louisburg, Cape Breton Co.

Occupation of Father at Birth of child Policeman Place of birth of Father Sydney Mines, Cape Breton Co.

Race English Name and present address of Physician in attendance at birth Dr. D. A. Morrison

Signature of Applicant F. P. Peck Address of Applicant Edmonton, Alberta Date 3 December 1948

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Francis PatrickPeck

Born at Louisburg in the County of Cape Breton

That Francis PatrickPeck Whose Birth is sought to be registered was

born at Louisburg Cape Breton County on July 19, 1920

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

Baptismal certificate attached

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