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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100024

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of ClarenceGriffin Sex Male

Date of Birth July 5, 1922 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Michael Griffin MAIDEN NAME of Mother Veronica Rice

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

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Clarence Griffin Address of Applicant 3524 Wood Avenue, New Waterford, Cape Breton Date 8 October 1985

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of ClarenceGriffin

Born at New Waterford in the County of Cape Breton

That ClarenceGriffin Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on July 5, 1922

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

Certificate of Baptism issued by Mount Carmel Parish My mother and father told me I was born on the 5th day of July 1922 at New Waterford aforesaid

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