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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000134

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Roderick OswaldBlack Sex Male

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

Name of Father Stephen Black MAIDEN NAME of Mother Mary Campbell

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

Residence of Father when child was born Sydney Present address of Father 69 Gritton Ave. Sydney

Occupation of Father at Birth of child Carpenter Place of birth of Father Grand Mira

Race Scottish Name and present address of Physician in attendance at birth

Signature of Applicant R.O. Black Address of Applicant Apt. 16 N.S.T.C. Halifax Date May 6, 1950

Relationship of Applicant to child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Roderick OswaldBlack

Born at Sydney in the County of Cape Breton

That Roderick OswaldBlack Whose Birth is sought to be registered was

born at Sydney Cape Breton County on February 29, 1920

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

Baptismal Certificate.

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