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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000476

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of HarryScott Sex Male

Date of Birth May 24, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father George Scott MAIDEN NAME of Mother Mary MacDonald

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 Coal Miner Place of birth of Father Union of Soviet Socialist Republic

Race Name and present address of Physician in attendance at birth

Signature of Applicant Harry Scott Address of Applicant 106 Borden Street, Glace Bay, Cape Breton Co., NS Date 28 August 1973

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That HarryScott Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 24, 1923

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

Particulars of the date of my birth and date of baptism set forth in the records of St. Anne's Church, Glace Bay, NS and set forth in a certificate of such baptism attested by the Parish Priest of such Church. Both of my parents are dead and I know of no record of my birth other than that contained in the register of baptism in the said Church.

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