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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700174

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 27, 1919 Place of Birth LinganCounty of Cape Breton

Name of Father Michael Rupert MAIDEN NAME of Mother Maria Seabank

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

Residence of Father when child was born Lingan Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Austria

Race Name and present address of Physician in attendance at birth Dr. A.W. Miller

Signature of Applicant Michael Rupert Address of Applicant Lingan Date 30 December 1919

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Lingan in the County of Cape Breton

That WilliamRupert Whose Birth is sought to be registered was

born at Lingan Cape Breton County on December 27, 1919

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

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