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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000924

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Joseph NorvilleGouthro Sex Male

Date of Birth April 4, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father Benjamin Gouthro MAIDEN NAME of Mother Annie Murphy

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

Residence of Father when child was born New Aberdeen, Glace Bay Present address of Father deceased

Occupation of Father at Birth of child Miner Place of birth of Father French Vale

Race Name and present address of Physician in attendance at birth

Signature of Applicant J.N. Gouthro Address of Applicant Hinton, Alberta Date July 7, 1978

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Joseph NorvilleGouthro

Born at Glace Bay in the County of Cape Breton

That Joseph NorvilleGouthro Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on April 4, 1920

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

I am the person who seeks to register my birth and I know my date and place of birth.

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