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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000069

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth September 23, 1922 Place of Birth New GlasgowCounty of Pictou

Name of Father Steven Hossack MAIDEN NAME of Mother Catherine Dominuc

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

Residence of Father when child was born New Glasgow, Pictou Present address of Father Ingersoll, Ontario

Occupation of Father at Birth of child Labourer Place of birth of Father Austria

Race Name and present address of Physician in attendance at birth

Signature of Applicant Steven Hossack Address of Applicant Ingersoll, Ontario Date 18 May 1948

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at New Glasgow in the County of Pictou

That WilliamHossack Whose Birth is sought to be registered was

born at New Glasgow Pictou County on September 23, 1922

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

My personal knowledge and clear recollection of the birth of my said son and I was present at the time of his birth.

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