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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000488

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William ArthurBurt Sex Male

Date of Birth September 13, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father George Burt MAIDEN NAME of Mother Rose 

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

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

Occupation of Father at Birth of child Sheet Metal Worker Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant William A. Burt Address of Applicant 260 King Street, Gananoque, Ontario Date 23 January 1976

Relationship of Applicant to child Himself

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William ArthurBurt

Born at Sydney in the County of Cape Breton

That William ArthurBurt Whose Birth is sought to be registered was

born at Sydney Cape Breton County on September 13, 1924

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

My certificate of Baptism, issued by the Diocese of Nova Scotia, a certified copy of which is attached hereto and marked Exhibit "A"

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