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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100329

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William Augustine Allen JosephChisholm Sex Male

Date of Birth August 5, 1920 Place of Birth St. AndrewsCounty of Antigonish

Name of Father John William Chisholm MAIDEN NAME of Mother Mary MacGillivray

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

Residence of Father when child was born St. Andrews Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Augustine Chisholm Address of Applicant Antigonish Date March 27, 1985

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William Augustine Allen JosephChisholm

Born at St. Andrews in the County of Antigonish

That William Augustine Allen JosephChisholm Whose Birth is sought to be registered was

born at St. Andrews Antigonish County on August 5, 1920

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

Church Record

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