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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000399

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Janes DanielFraser Sex Male

Date of Birth May 7, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father James Alexander Fraser MAIDEN NAME of Mother Mary Elizabeth Campbell

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 Dead

Occupation of Father at Birth of child Pattern Maker Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant James Daniel Fraser Address of Applicant 14 Rockdale Drive, Glace Bay, Cape Breton Co., NS Date 16 January 1971

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Janes DanielFraser

Born at Glace Bay in the County of Cape Breton

That Janes DanielFraser Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 7, 1923

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

1. Birth, Baptismal certificate enclosed, family history

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