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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000492

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Walter KennethCoombs Sex Male

Date of Birth December 26, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Herbert Coombs MAIDEN NAME of Mother Annie Kelland

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

Residence of Father when child was born 104 Richmond Street, Sydney, Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Steel Worker Place of birth of Father Harbour Grace, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mr. Walter K. Coombs Address of Applicant Site 24, Compartment 4, South Bar, Sydney, Cape Breton Co., NS Date 3 March 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Walter KennethCoombs

Born at Sydney in the County of Cape Breton

That Walter KennethCoombs Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 26, 1924

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

Certificate of Baptism

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