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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000117

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Archibald RalphaelGillis Sex Male

Date of Birth October 24, 1921 Place of Birth North SydneyCounty of Cape Breton

Name of Father John P.  Gillis MAIDEN NAME of Mother Sarah Catherine MacKinzie

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

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

Occupation of Father at Birth of child Coal Miner Place of birth of Father Bever Cove

Race Scottish Name and present address of Physician in attendance at birth D.R. MacRae

Signature of Applicant Archibald R. Gillis Address of Applicant Pleasant St. North Sydney Date January 1950

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Archibald RalphaelGillis

Born at North Sydney in the County of Cape Breton

That Archibald RalphaelGillis Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on October 24, 1921

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

that I was Spouses when he was baptized at St. Josephs Church at North Sydney October 30, 1921 (Certificate of Baptism from Church records attached)

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