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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000502

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Austin PatrickJessome Sex Male

Date of Birth March 17, 1920 Place of Birth Georges RiverCounty of Cape Breton

Name of Father Joseph Jessome MAIDEN NAME of Mother Jennie McSween

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

Residence of Father when child was born George River Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father George River

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

Signature of Applicant A.P. Jessome Address of Applicant Sydney River Date December 11, 1969

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Austin PatrickJessome

Born at Georges River in the County of Cape Breton

That Austin PatrickJessome Whose Birth is sought to be registered was

born at Georges River Cape Breton County on March 17, 1920

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

Baptismal certificate attached and marked "A" by the Commissioner swearing me hereto.

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