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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000550

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Courtney BanfordRushton Sex

Date of Birth April 5, 1920 Place of Birth AmherstCounty of Cumberland

Name of Father Clarence W.  Rushton MAIDEN NAME of Mother Theresa Jane Meagher

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

Residence of Father when child was born Amherst Present address of Father deceased

Occupation of Father at Birth of child Laborer Place of birth of Father Londonderry

Race Canadian Name and present address of Physician in attendance at birth Dr. B. Goodwin (Deceased)

Signature of Applicant Courtney B. Rushton Address of Applicant 21 Raglan Ave, Apt. 2, Toronto, Ontario Date February 2, 1971

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Courtney BanfordRushton

Born at Amherst in the County of Cumberland

That Courtney BanfordRushton Whose Birth is sought to be registered was

born at Amherst Cumberland County on April 5, 1920

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

Family Bible and Cradle Race Certificate, enrolled July 5, 1920. (--- in Army) N. Scotia. R.B. Justice of the Peace.

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