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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000378

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 21, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Arthur W. Pickles MAIDEN NAME of Mother Frances Perry

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

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

Occupation of Father at Birth of child Electrician Place of birth of Father Sydney Mines, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant William F. Pickles Address of Applicant 208 St. Clarens Avenue, Toronto, Ontario Date 17 September 1969

Relationship of Applicant to child I am the applicant

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That William FrancisPickles Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 21, 1922

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

I am the applicant I know my place and death (date) of birth and my certificate of baptism confirms this

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