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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700063

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Richard TheophilusBuffett Sex Male

Date of Birth December 17, 1919 Place of Birth North SydneyCounty of Cape Breton

Name of Father Theophilus Buffett MAIDEN NAME of Mother Elizabeth Strong

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

Residence of Father when child was born North Sydney Present address of Father Catherine St.

Occupation of Father at Birth of child Plasterer Place of birth of Father Burges, Nfld

Race Name and present address of Physician in attendance at birth Dr. M.J. McLean

Signature of Applicant Theophilus Buffett Address of Applicant Catherine St., North Sydney Date 31 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Richard TheophilusBuffett

Born at North Sydney in the County of Cape Breton

That Richard TheophilusBuffett Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on December 17, 1919

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

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