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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100156

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of CharlesCampbell Sex Male

Date of Birth June 26, 1920 Place of Birth WoodbineCounty of Cape Breton

Name of Father Angus Campbell MAIDEN NAME of Mother Mamie Simpson

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

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

Occupation of Father at Birth of child Steelworker Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Charles Campbell Address of Applicant Sydney Date January 22, 1982

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of CharlesCampbell

Born at Woodbine in the County of Cape Breton

That CharlesCampbell Whose Birth is sought to be registered was

born at Woodbine Cape Breton County on June 26, 1920

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

Certificate of Baptism

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