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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000901

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Cecil LawrenceMason Sex Male

Date of Birth September 4, 1923 Place of Birth PondsCounty of Pictou

Name of Father Henry Mason MAIDEN NAME of Mother Ada Arbuckle

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

Residence of Father when child was born Merigomish Pictou Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Ponds, Pictou Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Cecil L. Mason Address of Applicant 107 McClary Avenue, Apt 1, Rear London, Ontario Date 26 July 1984

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Cecil LawrenceMason

Born at Ponds in the County of Pictou

That Cecil LawrenceMason Whose Birth is sought to be registered was

born at Ponds Pictou County on September 4, 1923

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

Census report - Dated April 8, 1983 Statement of Service in Canadian Armed Forces - Date January 22, 1975 Marriage Certificate - to be searched in Nova Scotia - see details enclosed

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