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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000916

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Philip MichaelJessome Sex Male

Date of Birth August 16, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Leo W. Jessome MAIDEN NAME of Mother Minnie Turner

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

Residence of Father when child was born 338 George Street, Sydney, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Mechanic (Auto) Place of birth of Father Sydney Mines, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant P. M. Jessome, D. C. Address of Applicant 326 Champlain, Sydney, Cape Breton Date 18 November 1982

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Philip MichaelJessome

Born at Sydney in the County of Cape Breton

That Philip MichaelJessome Whose Birth is sought to be registered was

born at Sydney Cape Breton County on August 16, 1922

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

Certificate of birth and baptism dated 17 November 1982 from Sacred Heart parish in Sydney, Cape Breton. Class A evidence (C).

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