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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000508

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James CecilRoss Sex Male

Date of Birth June 29, 1922 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father James Ross MAIDEN NAME of Mother Elizabeth McKinnon

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 Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant James Cecil Ross Address of Applicant 332 Townsend Street, Sydney, Cape Breton Date 12 March 1*974

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James CecilRoss

Born at Sydney Mines in the County of Cape Breton

That James CecilRoss Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on June 29, 1922

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

A copy of the registration of birth at the Salvation Army, Sydney Mines, Corps, Sydney Mines which is enclosed and a copy of certificate of dedication that has date of birth on it, also enclosed.

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