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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000984

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John JamesGardiner Sex Male

Date of Birth July 25, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father Mark Gardiner MAIDEN NAME of Mother Jean MacDonald

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

Residence of Father when child was born Arthur Street Glace Bay Cape Breton Co. Ns Present address of Father Deceaseed

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant John James Gardiner Address of Applicant Marion Bridge, Cape Breton Co., NS Date 23 March 1989

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John JamesGardiner

Born at Glace Bay in the County of Cape Breton

That John JamesGardiner Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on July 25, 1923

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

With certificate from Parish of Baptism

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