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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100081

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James WilliamJessome Sex Male

Date of Birth July 14, 1922 Place of Birth New VictoriaCounty of Cape Breton

Name of Father John Jessome MAIDEN NAME of Mother Teresa McGillivray

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

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

Occupation of Father at Birth of child Labourer - Railroad Place of birth of Father Alder Point, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant James William Jessome Address of Applicant Wallace Road, New Victoria, Cape Breton Date April 1986

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James WilliamJessome

Born at New Victoria in the County of Cape Breton

That James WilliamJessome Whose Birth is sought to be registered was

born at New Victoria Cape Breton County on July 14, 1922

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

Baptismal Certificate

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