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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000758

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Katherine DorothyGouthro Sex Female

Date of Birth September 26, 1921 Place of Birth North SydneyCounty of Cape Breton

Name of Father William Gouthro MAIDEN NAME of Mother Theresa MacLellan

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

Residence of Father when child was born North Sydney Present address of Father deceased

Occupation of Father at Birth of child Coal Shipper Dominion Coal Company Place of birth of Father Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dorothy Gouthro Lambert Address of Applicant 30 Collins St. Glace Bay Date January 20, 1976

Relationship of Applicant to child same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Katherine DorothyGouthro

Born at North Sydney in the County of Cape Breton

That Katherine DorothyGouthro Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on September 26, 1921

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

It is the date shown on the attached Certificate of Birth and Baptism particulars on which have been taken from the Church Records at St. Josephs Church, North Sydney and a copy of which Certificate was already forwarded to the Deputy Registrar Generals office at Halifax.

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