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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000979

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Charles JosephChisholm Sex Male

Date of Birth February 3, 1921 Place of Birth Port HawkesburyCounty of Inverness

Name of Father Christopher Alexander Chisholm MAIDEN NAME of Mother Mary Barbara Anderson

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

Residence of Father when child was born Port Hawkesbury Present address of Father

Occupation of Father at Birth of child Merchant Place of birth of Father Port Hawkesbury

Race Name and present address of Physician in attendance at birth

Signature of Applicant Joseph C. Chisholm Address of Applicant 27 Hankard St. Sydney Date July 9, 1982

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Charles JosephChisholm

Born at Port Hawkesbury in the County of Inverness

That Charles JosephChisholm Whose Birth is sought to be registered was

born at Port Hawkesbury Inverness County on February 3, 1921

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

1) Baptismal Certificate (enclosed) 2) Memory

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