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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000309

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clarence WilliamLong Sex Male

Date of Birth September 2, 1923 Place of Birth North SydneyCounty of Cape Breton

Name of Father Thomas Long MAIDEN NAME of Mother Edith McAuley

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

Residence of Father when child was born North Sydney Cape Breton Co. Ns Present address of Father North Sydney, Cape Breton Co., NS

Occupation of Father at Birth of child Coal Shipper, Scotia Pier Place of birth of Father Nova Scotia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Thomas Long Address of Applicant North Sydney, Cape Breton Co., NS Date 10 October 1927

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clarence WilliamLong

Born at North Sydney in the County of Cape Breton

That Clarence WilliamLong Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on September 2, 1923

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

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