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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000794

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Michael GeraldGouthro Sex Male

Date of Birth September 19, 1922 Place of Birth DominionCounty of Cape Breton

Name of Father William James Gouthro MAIDEN NAME of Mother Annie McNeil

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

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

Occupation of Father at Birth of child Miner Place of birth of Father Frenchvale, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Michael G. Gouthro Address of Applicant Gardiner Road, Dominion, Cape Breton Date 8 February 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Michael GeraldGouthro

Born at Dominion in the County of Cape Breton

That Michael GeraldGouthro Whose Birth is sought to be registered was

born at Dominion Cape Breton County on September 19, 1922

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

Certificate of birth School registration Marriage certificate

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