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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000839

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Francis DavidPiercey Sex Male

Date of Birth May 17, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father David Piercey MAIDEN NAME of Mother Margaret Hayes

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 Steel worker Place of birth of Father Bay of Islands, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Francis David Piercey Address of Applicant 213 East Broadway, Sydney, Cape Breton Date 17 January 1981

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Francis DavidPiercey

Born at Sydney in the County of Cape Breton

That Francis DavidPiercey Whose Birth is sought to be registered was

born at Sydney Cape Breton County on May 17, 1922

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

This is my own birth

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