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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100033

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Francis AdrianGillis Sex Male

Date of Birth September 7, 1923 Place of Birth PasschendaeleCounty of Cape Breton

Name of Father Alex Gillis MAIDEN NAME of Mother Mary MacKinnon

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

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

Occupation of Father at Birth of child Miner Place of birth of Father Glace Bay, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Francis A. Gillis Address of Applicant 7 East Street, Donkin, Cape Breton Co., NS Date 4 May 1988

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Francis AdrianGillis

Born at Passchendaele in the County of Cape Breton

That Francis AdrianGillis Whose Birth is sought to be registered was

born at Passchendaele Cape Breton County on September 7, 1923

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

Certificate of baptism attached. Marriage extract.

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