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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000715

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alphonsus JosephFagan Sex

Date of Birth November 28, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Alban Joseph Fagan MAIDEN NAME of Mother Esther Lee

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

Residence of Father when child was born 108 West St., Sydney Present address of Father deceased

Occupation of Father at Birth of child Steelworker Place of birth of Father Riverhead, St. Mary's, NFld.

Race Name and present address of Physician in attendance at birth

Signature of Applicant A.J. Fagan Address of Applicant 31 Stornaway St., Sydney Date December 5, 1974

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alphonsus JosephFagan

Born at Sydney in the County of Cape Breton

That Alphonsus JosephFagan Whose Birth is sought to be registered was

born at Sydney Cape Breton County on November 28, 1920

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

Baptismal Record.

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