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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000239

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth September 11, 1922 Place of Birth North SydneyCounty of Cape Breton

Name of Father George Brushett MAIDEN NAME of Mother Jessie Farrell

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

Residence of Father when child was born North Sydney, Cape Breton Present address of Father Decesed

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant R. K. Burshett Address of Applicant 38 Willow Street Date 26 November 1958

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at North Sydney in the County of Cape Breton

That ReginaldBrushett Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on September 11, 1922

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

Army discharge shown the given name as John. School record.

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