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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100099

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Philip EdwinBagnell Sex Male

Date of Birth January 20, 1920 Place of Birth North SydneyCounty of Cape Breton

Name of Father William F. Bagnell MAIDEN NAME of Mother Ethel Bragg

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

Residence of Father when child was born Cornwall Street, North Sydney Present address of Father deceased

Occupation of Father at Birth of child Part owner, furniture store Place of birth of Father Gabarus, Cape Breton Co.

Race Name and present address of Physician in attendance at birth

Signature of Applicant Philip E. Bagnell Address of Applicant 20 Common Street, Sydney, Cape Breton Date 10 December 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Philip EdwinBagnell

Born at North Sydney in the County of Cape Breton

That Philip EdwinBagnell Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on January 20, 1920

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

Baptismal

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