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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100291

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James JosephMcKillop Sex Male

Date of Birth September 8, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father James McKillop MAIDEN NAME of Mother Mary O'Connell

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

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

Occupation of Father at Birth of child No. 5 Colliery Place of birth of Father St. John's, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant James Joseph McKillop Address of Applicant Glace Bay Date November 13, 1984

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James JosephMcKillop

Born at Glace Bay in the County of Cape Breton

That James JosephMcKillop Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on September 8, 1920

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

It is the date shown on the certificate of Birth and Baptism from St. John's Church already forwarded to the office of the Deputy Registrar General.

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