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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000325

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth February 28, 1924 Place of Birth HalifaxCounty of Halifax

Name of Father Francis Dacey MAIDEN NAME of Mother Mary Buckley

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

Residence of Father when child was born Halifax, NS Present address of Father Deceased

Occupation of Father at Birth of child Packer Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Francis A. Dacey Address of Applicant 2780 Isleville Street, Halifax, NS Date 3 September 1969

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Halifax in the County of Halifax

That Francis AlexanderDacey Whose Birth is sought to be registered was

born at Halifax Halifax County on February 28, 1924

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

Certificate of baptism

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