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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000567

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Raymond JohnAndrews Sex Male

Date of Birth April 5, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Jacob Aaron Andrews MAIDEN NAME of Mother Annie Osmond

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

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

Occupation of Father at Birth of child Steelworker Place of birth of Father Hearts Desire, Newfoundland & Labrador

Race White Name and present address of Physician in attendance at birth midwife (Deceased)

Signature of Applicant Raymond John Andrews Address of Applicant 83 Fairhaven Drive, Westmount Sydney Date 7 September 1971

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Raymond JohnAndrews

Born at Sydney in the County of Cape Breton

That Raymond JohnAndrews Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 5, 1920

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

that I am the said party's mother and that Raymond John Andrews described above is my son

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