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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100124

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Burton IsaacPatterson Sex Male

Date of Birth April 7, 1921 Place of Birth Coal HarbourCounty of Halifax

Name of Father Isaac Patterson MAIDEN NAME of Mother Annie Conrad

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

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

Occupation of Father at Birth of child Fisherman Place of birth of Father Lawrencetown

Race Name and present address of Physician in attendance at birth

Signature of Applicant Burton I. Patterson Address of Applicant RR1 Dartmouth Date October 2, 1985

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Burton IsaacPatterson

Born at Coal Harbour in the County of Halifax

That Burton IsaacPatterson Whose Birth is sought to be registered was

born at Coal Harbour Halifax County on April 7, 1921

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

Baptismal Parents Marriage Census forms

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