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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000829

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John DavidWilliams Sex

Date of Birth August 19, 1920 Place of Birth WestmountCounty of Cape Breton

Name of Father Ralph Williams MAIDEN NAME of Mother Hattie Spears

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

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Canso

Race Name and present address of Physician in attendance at birth

Signature of Applicant John David Williams Address of Applicant 141 Riverside Drive (Sydney) Date April 4, 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John DavidWilliams

Born at Westmount in the County of Cape Breton

That John DavidWilliams Whose Birth is sought to be registered was

born at Westmount Cape Breton County on August 19, 1920

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

Information received form parents. Baptismal Certificate (attached)

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