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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000654

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of CarolineGosse Sex Female

Date of Birth April 7, 1923 Place of Birth North SydneyCounty of Cape Breton

Name of Father Richard Gosse MAIDEN NAME of Mother Margaret Martin

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 59 Elm Street, Port Colborne, Ontario

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Caroline Camp Address of Applicant 518 Leonard Avenue, Welland, Ontario Date 12 May 1978

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at North Sydney in the County of Cape Breton

That CarolineGosse Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on April 7, 1923

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

I am Caroline's older sister and we were raised together and have always been very close.

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