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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100021

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William HenryWalters Sex Male

Date of Birth December 25, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Frederick Walters MAIDEN NAME of Mother Lillian Fillmore

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

Residence of Father when child was born Grand Lake Rd. Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Bristol, England

Race Name and present address of Physician in attendance at birth

Signature of Applicant William Walters Address of Applicant 39 Armstrong Crt. Sydney Date July 26, 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William HenryWalters

Born at Sydney in the County of Cape Breton

That William HenryWalters Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 25, 1921

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

Census Records National Registration

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