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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000575

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Thomas CharlesBartlett Sex

Date of Birth May 21, 1920 Place of Birth North SydneyCounty of Cape Breton

Name of Father Thomas Elias Bartlett MAIDEN NAME of Mother Bertha Prizeman

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

Residence of Father when child was born North Sydney Present address of Father deceased

Occupation of Father at Birth of child Miner Place of birth of Father Fortune Bay, Nfld

Race English Name and present address of Physician in attendance at birth Deceased

Signature of Applicant Yvette N. Bartlett Address of Applicant 47A Shore Rd, Sydney Mines Date September 23, 1971

Relationship of Applicant to child Wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Thomas CharlesBartlett

Born at North Sydney in the County of Cape Breton

That Thomas CharlesBartlett Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on May 21, 1920

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

Service Certificate, Marriage License, Family Bible, Friends and Neighbors.

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