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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000560

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth September 17, 1923 Place of Birth New WaterfordCounty of Cape Breton

Name of Father James Wiseman MAIDEN NAME of Mother Agnes Henry

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

Residence of Father when child was born New Waterford Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Charles Wiseman Address of Applicant 19 Madock Drive, Toronto, Ontario Date 11 March 1976

Relationship of Applicant to child One and the same

AFFIDAVIT

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

Born at New Waterford in the County of Cape Breton

That CharlesWiseman Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on September 17, 1923

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

Certificate of birth and baptism

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