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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000189

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of RossHickey Sex Male

Date of Birth May 31, 1924 Place of Birth North SydneyCounty of Cape Breton

Name of Father John Hickey MAIDEN NAME of Mother Madeline Poole

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

Residence of Father when child was born North Sydney, Cape Breton Co., NS Present address of Father Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ross Hickey Address of Applicant Ralston, Alberta Date 18 April 1957

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of RossHickey

Born at North Sydney in the County of Cape Breton

That RossHickey Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on May 31, 1924

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

School record (Exhibit A) Passport Army record

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