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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000841

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Douglas CalebTaylor Sex Male

Date of Birth September 12, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father Matthew Taylor MAIDEN NAME of Mother Fanny Burte

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 Miner Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Douglas Caleb Taylor Address of Applicant 130 Cherwood Street, St. Catharines, Ontario, L2S 2A9 Date 28 October 1982

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Douglas CalebTaylor

Born at Glace Bay in the County of Cape Breton

That Douglas CalebTaylor Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on September 12, 1923

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

I am the natural mother of Douglas Caleb Taylor. the hospital birth certificate and baptismal certificate are presented with this application.

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