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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100075

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Michael VincentWilliams Sex Male

Date of Birth May 2, 1921 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Edward Williams MAIDEN NAME of Mother Charlotte Hall

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

Residence of Father when child was born New Waterford Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Michael V. Williams Address of Applicant 3490 Wilson AVe. New Waterford Date December 28, 1984

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Michael VincentWilliams

Born at New Waterford in the County of Cape Breton

That Michael VincentWilliams Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on May 2, 1921

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

Baptismal

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