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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000741

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Archibald JeromeCameron Sex Male

Date of Birth July 23, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Daniel Thomas Cameron MAIDEN NAME of Mother Elizabeth Bridget  Poolain

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

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

Occupation of Father at Birth of child Tailor Place of birth of Father Cape North

Race Name and present address of Physician in attendance at birth

Signature of Applicant A.J. Cameron Address of Applicant Trout Brook Road Date July 17, 1975

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Archibald JeromeCameron

Born at Sydney in the County of Cape Breton

That Archibald JeromeCameron Whose Birth is sought to be registered was

born at Sydney Cape Breton County on July 23, 1920

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

Baptismal Certificate

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