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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000065

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John GilbertBustin Sex Male

Date of Birth June 11, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father John H. Bustin MAIDEN NAME of Mother Madeline Fletcher

Residence of Father when child was born Windsor Hants Co. Ns Present address of Father Windsor, Hants Co., NS

Occupation of Father at Birth of child Merchant Place of birth of Father Moncton, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant John G. Bustin Address of Applicant Windsor, Hants Co., NS Date 10 October 1942

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John GilbertBustin

Born at Halifax in the County of Halifax

That John GilbertBustin Whose Birth is sought to be registered was

born at Halifax Halifax County on June 11, 1923

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

That I am the father of the said child, John Gilbert Bustin

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