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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100328

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William Penny Sex Male

Date of Birth October 31, 1920 Place of Birth FlorenceCounty of Cape Breton

Name of Father John Charles Penny MAIDEN NAME of Mother Elizabeth Clark

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

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

Occupation of Father at Birth of child Coal miner Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant William Penny Address of Applicant Florence Date February 5, 1985

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William Penny

Born at Florence in the County of Cape Breton

That William Penny Whose Birth is sought to be registered was

born at Florence Cape Breton County on October 31, 1920

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

Baptism Certificate

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