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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93400725

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James HenryGouthro Sex Male

Date of Birth September 6, 1906 Place of Birth DominionCounty of Cape Breton

Name of Father Alonzo Gouthro MAIDEN NAME of Mother Martha Corbett

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

Occupation of Father at Birth of child Miner Place of birth of Father French Vale

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

Signature of Applicant James Henry Gouthro Address of Applicant Dominion Date 11 January 1926

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James HenryGouthro

Born at Dominion in the County of Cape Breton

That James HenryGouthro Whose Birth is sought to be registered was

born at Dominion Cape Breton County on September 6, 1906

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

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