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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000269

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of WilliamGoodman Sex Male

Date of Birth April 5, 1921 Place of Birth Bras d'OrCounty of Cape Breton

Name of Father Norman Beaton Goodman MAIDEN NAME of Mother Nellie Millar

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

Residence of Father when child was born Bras d'Or Road Present address of Father deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Scotland

Race White Name and present address of Physician in attendance at birth deceased

Signature of Applicant Nellie Clark Goodman Address of Applicant 2960 Beechwood, Lynwood, California, USA Date November 29, 1958

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of WilliamGoodman

Born at Bras d'Or in the County of Cape Breton

That WilliamGoodman Whose Birth is sought to be registered was

born at Bras d'Or Cape Breton County on April 5, 1921

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

School Record Family Record

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