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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000625

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Herbert CarltonAnderson Sex

Date of Birth January 11, 1920 Place of Birth North SydneyCounty of Cape Breton

Name of Father William Oscar Anderson MAIDEN NAME of Mother Elsie Grace Hughes

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 Teamster Place of birth of Father Nova Scotia

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

Signature of Applicant Herbert Carlton Anderson Address of Applicant 309 Woodward Ave, Hamilton, Ontario Date August 13, 1969

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Herbert CarltonAnderson

Born at North Sydney in the County of Cape Breton

That Herbert CarltonAnderson Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on January 11, 1920

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

Enclosed a Baptismal Certificate from St Pauls Parish.

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