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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000801

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John HughBlack Sex Male

Date of Birth August 26, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Stephen R. Black MAIDEN NAME of Mother Mary Campbell

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 Carpenter Place of birth of Father Grand Mira, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Catherine Campbell Address of Applicant 219 Argyle Street, Sydney, Cape Breton Date 4 July 1979

Relationship of Applicant to child Aunt

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John HughBlack

Born at Sydney in the County of Cape Breton

That John HughBlack Whose Birth is sought to be registered was

born at Sydney Cape Breton County on August 26, 1922

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

I am an Aunt of Joh Hugh Black and well remember the date of his birth. See attached certificate of Baptism.

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