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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000177

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of KathleenButler Sex Female

Date of Birth December 9, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father Stephen Butler MAIDEN NAME of Mother Ruth Scott

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

Residence of Father when child was born Glace Bay Cape Breton Co. Ns Present address of Father Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. W. Proctor Address of Applicant 705 Barrington Street, Halifax, NS Date May 1954

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That KathleenButler Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 9, 1923

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

1. Certificate of Rev. Joseph A. Campbell, St. John's Parish, Glace Bay, Cape Breton Co., NS, Exhibit "A" 2. Knowledge of my age since age of reason.

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