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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000460

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ambrose FabianShea Sex Male

Date of Birth June 1, 1924 Place of Birth Glace BayCounty of Cape Breton

Name of Father Ambrose Shea MAIDEN NAME of Mother Margaret McPhee

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

Residence of Father when child was born 358 4th 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 Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Joanne Gould Address of Applicant Shea Lane, Glace Bay, Cape Breton Co., NS Date 28 May 1975

Relationship of Applicant to child Friend

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ambrose FabianShea

Born at Glace Bay in the County of Cape Breton

That Ambrose FabianShea Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on June 1, 1924

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

Baptism certificate

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