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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000192

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Stephen FrancisMalloy Sex Male

Date of Birth September 25, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Frank Malloy MAIDEN NAME of Mother Kate Young

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

Residence of Father when child was born Glace Bay, Cape Breton Present address of Father 43 Brookland Street, Glace Bay, Cape Breton

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Stephen F. Malloy Address of Applicant Box 419, Bronte, Ontario Date 8 July 1955

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Stephen FrancisMalloy

Born at Glace Bay in the County of Cape Breton

That Stephen FrancisMalloy Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on September 25, 1922

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

possession of certificate of baptism

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