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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000469

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clarence EverettBennett Sex Male

Date of Birth January 25, 1924 Place of Birth North SydneyCounty of Cape Breton

Name of Father Adolph Bennett MAIDEN NAME of Mother Minnie Young

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 Ships Cook Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant C. E. Bennett Address of Applicant Box 115, Likely, British Columbia Date 24 June 1975

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clarence EverettBennett

Born at North Sydney in the County of Cape Breton

That Clarence EverettBennett Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on January 25, 1924

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

Certificate of birth and baptism supplied by St. Joseph's Parish, North Sydney, NS and attached hereto

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