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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000107

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Angus PatrickPendergast Sex Male

Date of Birth October 29, 1921 Place of Birth Mill CreekCounty of Cape Breton

Name of Father Walter Pendergast MAIDEN NAME of Mother Catherine Chisholm

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

Residence of Father when child was born Mill Creek Present address of Father Mill Creek

Occupation of Father at Birth of child Farmer Place of birth of Father Mill Creek

Race Irish Name and present address of Physician in attendance at birth Dr. V.T. McKeough

Signature of Applicant Walter Pendergast Address of Applicant Mill Creek Date March 8, 1949

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Angus PatrickPendergast

Born at Mill Creek in the County of Cape Breton

That Angus PatrickPendergast Whose Birth is sought to be registered was

born at Mill Creek Cape Breton County on October 29, 1921

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

I am his father and I attach a Certificate of Baptism

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