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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000988

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Daniel JosephKiley Sex Male

Date of Birth February 11, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father James Kiley MAIDEN NAME of Mother Stella Young

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

Residence of Father when child was born 592 Roost St. Glace Bay Present address of Father dead

Occupation of Father at Birth of child Miner Place of birth of Father Canso

Race Name and present address of Physician in attendance at birth

Signature of Applicant Daniel Joseph Kiley Address of Applicant 121 Wallace Rd. Glace Bay Date August 31, 1982

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Daniel JosephKiley

Born at Glace Bay in the County of Cape Breton

That Daniel JosephKiley Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on February 11, 1921

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

It is the date shown on the Certificate of Birth and Baptism attached herewith, particulars on the Certificate taken from the records as St. Johns Church, New Aberdeen, Glace Bay.

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