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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000577

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kenneth EdwardBlackburn Sex Male

Date of Birth March 7, 1924 Place of Birth HalifaxCounty of Halifax

Name of Father Michael Blackburn MAIDEN NAME of Mother Mary McDonald

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

Residence of Father when child was born Halifax, NS Present address of Father 5137 Morris Street, Halifax, NS

Occupation of Father at Birth of child Longshoreman Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Kenneth Blackburn Address of Applicant 5137 Morris Street, Halifax, NS Date 16 May 1978

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kenneth EdwardBlackburn

Born at Halifax in the County of Halifax

That Kenneth EdwardBlackburn Whose Birth is sought to be registered was

born at Halifax Halifax County on March 7, 1924

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

Baptismal Marriage Extract

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