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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000954

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John WilfredPeters Sex Male

Date of Birth January 24, 1921 Place of Birth AntigonishCounty of Antigonish

Name of Father Jerome Peters MAIDEN NAME of Mother Catherine Gallant

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

Residence of Father when child was born Antigonish Present address of Father deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father Prince Edward Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Wilfred J. Peters Address of Applicant 102 Sunrise Drive Weymouth, Massachusetts, USA Date November 24, 1981

Relationship of Applicant to child same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John WilfredPeters

Born at Antigonish in the County of Antigonish

That John WilfredPeters Whose Birth is sought to be registered was

born at Antigonish Antigonish County on January 24, 1921

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

All my records so indicate also enclosed is sealed copy of Baptism received from St. Ninians Cathedral N.S.

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