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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000588

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 3, 1921 Place of Birth Goose CoveCounty of Victoria

Name of Father Murdoch Matheson MAIDEN NAME of Mother Jessie Anne MacLeod

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

Residence of Father when child was born Goose Cove Present address of Father deceased

Occupation of Father at Birth of child unemployed Place of birth of Father Meadows

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jessie A. Matheson Address of Applicant RR1 South Hanen Date June 2, 1975

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Goose Cove in the County of Victoria

That AllanMatheson Whose Birth is sought to be registered was

born at Goose Cove Victoria County on December 3, 1921

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

Church Records. See attached letter

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