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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100035

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Charles MurdockCreighton Sex Male

Date of Birth June 24, 1920 Place of Birth Sydney ForksCounty of Cape Breton

Name of Father Charles Murdock Creighton MAIDEN NAME of Mother Florence Morrison

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father Pictou

Race Name and present address of Physician in attendance at birth

Signature of Applicant Charles Murdock Creighton Address of Applicant Sydney Date December 3, 1979

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Charles MurdockCreighton

Born at Sydney Forks in the County of Cape Breton

That Charles MurdockCreighton Whose Birth is sought to be registered was

born at Sydney Forks Cape Breton County on June 24, 1920

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

This is my own birth.

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