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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000123

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Keith BernardPowers Sex Male

Date of Birth November 19, 1920 Place of Birth North SydneyCounty of Cape Breton

Name of Father Bernard Lawrence Powers MAIDEN NAME of Mother Mary Marguerite Cahoon

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

Residence of Father when child was born Pier St. North Sydney Present address of Father 85 Pleasant St. Dartmouth

Occupation of Father at Birth of child Telegrapher Place of birth of Father Dorchester, Massachusetts, USA

Race Irish Name and present address of Physician in attendance at birth Dr. Thomas Smith (deceased)

Signature of Applicant Bernard Lawrence Powers Address of Applicant 85 Pleasant St. Dartmouth Date June 8, 1949

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Keith BernardPowers

Born at North Sydney in the County of Cape Breton

That Keith BernardPowers Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on November 19, 1920

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

I am his father. Certificate of Baptism attached

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