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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000191

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Arthur RobertRoss Sex Male

Date of Birth February 21, 1922 Place of Birth Reserve MinesCounty of Cape Breton

Name of Father William Murdock Ross MAIDEN NAME of Mother Mary Keigen

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

Residence of Father when child was born Reserve Mines, Cape Breton Present address of Father RR #4, Banff Trail, Calgary, Alberta

Occupation of Father at Birth of child Miner Place of birth of Father Margaree, Inverness

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Mary Ross Address of Applicant RR #4, Banff Trail, Calgary, Alberta Date 29 November 1954

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Arthur RobertRoss

Born at Reserve Mines in the County of Cape Breton

That Arthur RobertRoss Whose Birth is sought to be registered was

born at Reserve Mines Cape Breton County on February 21, 1922

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

I was in attendance with Mrs. Mary Ross on birth of son, Arthur Robert Ross. (National registration record - court order)

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