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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700254

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Robert PeterWerner Sex Male

Date of Birth November 2, 1919 Place of Birth SydneyCounty of Cape Breton

Name of Father Mathew Werner MAIDEN NAME of Mother Maude Robson

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

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

Occupation of Father at Birth of child Engineer Place of birth of Father Russia

Race Name and present address of Physician in attendance at birth Dr. McAulay

Signature of Applicant Maude Werner Address of Applicant Sydney Date 01 December 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Robert PeterWerner

Born at Sydney in the County of Cape Breton

That Robert PeterWerner Whose Birth is sought to be registered was

born at Sydney Cape Breton County on November 2, 1919

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

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