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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000937

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Thomas MiltonJardine Sex Male

Date of Birth January 31, 1923 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father Andrew Jardine MAIDEN NAME of Mother Grace MacDonald

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

Residence of Father when child was born Sydney Mines Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Sydney Mines, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Milton Jardine Address of Applicant 25 King Street, Sydney Mines, Cape Breton Co., NS Date 25 September 1985

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Thomas MiltonJardine

Born at Sydney Mines in the County of Cape Breton

That Thomas MiltonJardine Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on January 31, 1923

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

Submission of Baptism certificate

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