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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90500280

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Russell ElbertBagnell Sex Male

Date of Birth April 1, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father George Franklin Bagnell MAIDEN NAME of Mother Josephine Abigail Northup

Residence of Father when child was born Glace Bay Present address of Father East St. John, New Brunswick

Occupation of Father at Birth of child Machinist Place of birth of Father St. John, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant Josephine Bagnell Address of Applicant East St. John, New Brunswick Date 22 August 1940

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Russell ElbertBagnell

Born at Glace Bay in the County of Cape Breton

That Russell ElbertBagnell Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on April 1, 1921

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

being his mother

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