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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93602376

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of DonaldChisholm Sex Male

Date of Birth October 7, 1906 Place of Birth SunnybraeCounty of Pictou

Name of Father Daniel Chisholm MAIDEN NAME of Mother Ida Robertson

Residence of Father when child was born Sunnybrae Present address of Father Sunnybrae

Occupation of Father at Birth of child Farmer Place of birth of Father Sunnybrae

Race Scottish Name and present address of Physician in attendance at birth Dr. H.D. Chisholm

Signature of Applicant Donald Chisholm Address of Applicant Springville Date 4 August 1926

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of DonaldChisholm

Born at Sunnybrae in the County of Pictou

That DonaldChisholm Whose Birth is sought to be registered was

born at Sunnybrae Pictou County on October 7, 1906

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

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