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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000812

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William JamesGibson Sex Male

Date of Birth August 4, 1923 Place of Birth St. PetersCounty of Richmond

Name of Father William Gibson MAIDEN NAME of Mother Emeline Peters

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

Residence of Father when child was born St. Peters Richmond Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father St. Peters

Race Name and present address of Physician in attendance at birth

Signature of Applicant Emerald W. Gibson Address of Applicant 11 Daliah Street, Dartmouth, NS Date 27 August 1981

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William JamesGibson

Born at St. Peters in the County of Richmond

That William JamesGibson Whose Birth is sought to be registered was

born at St. Peters Richmond County on August 4, 1923

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

Baptismal

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