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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000260

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William EdwardClinton Sex Male

Date of Birth June 17, 1922 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father William Edward Clinton MAIDEN NAME of Mother Carolina Ash

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

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

Occupation of Father at Birth of child Miner Place of birth of Father Mattie Settlement, Guysborough

Race Name and present address of Physician in attendance at birth

Signature of Applicant W. E. Clinton Address of Applicant Lower Sackville, Halifax Date 15 November 1960

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William EdwardClinton

Born at Sydney Mines in the County of Cape Breton

That William EdwardClinton Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on June 17, 1922

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

By sighting (citing) the certificate of baptism from the Immaculate Conception Parish, Sydney Mines which is attached hereto as Exhibit "A" to this my affidavit.

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