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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100063

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 19, 1922 Place of Birth DingwallCounty of Victoria

Name of Father   MAIDEN NAME of Mother Sadie Fitzgerald

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Michael Freeman Fitzgerald Address of Applicant Dingwall, Victoria Date 8 November 1986

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Dingwall in the County of Victoria

That Michael FreemanFitzgerald Whose Birth is sought to be registered was

born at Dingwall Victoria County on April 19, 1922

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

Certificate of baptism at Saint Joseph Parish

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