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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700522

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of David ChristianKeefe Sex Male

Date of Birth October 21, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father Arthur Edward Keefe MAIDEN NAME of Mother Hellena Bates

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

Residence of Father when child was born Glace Bay Present address of Father Dominion No. 4

Occupation of Father at Birth of child Electrician Place of birth of Father Sydney

Race Name and present address of Physician in attendance at birth Dr. M.T. Sullivan

Signature of Applicant Arthur Edward Keefe Address of Applicant Dominion No. 4, Glace Bay Date 12 January 1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of David ChristianKeefe

Born at Glace Bay in the County of Cape Breton

That David ChristianKeefe Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on October 21, 1919

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

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