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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000633

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Joseph EdwardWilliams Sex Male

Date of Birth October 8, 1923 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father   MAIDEN NAME of Mother Elizabeth Williams

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Elizabeth Williams Donovan Address of Applicant 53 Main Street, Sydney Mines, Cape Breton Co., NS Date 22 February 1978

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Joseph EdwardWilliams

Born at Sydney Mines in the County of Cape Breton

That Joseph EdwardWilliams Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on October 8, 1923

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

I am the natural mother of Joseph Edward Williams and gave birth to him at Sydney Mines, NS on October 8, 1923.

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