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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000581

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 1, 1924 Place of Birth IngonishCounty of Victoria

Name of Father   MAIDEN NAME of Mother Gertrude Gillis

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Walter Dominic Gillis Address of Applicant 11 Redwood Avenue, Toronto, Ontario Date June 1978

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Ingonish in the County of Victoria

That Walter DominicGillis Whose Birth is sought to be registered was

born at Ingonish Victoria County on July 1, 1924

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

My birthdate was made known to me by mother and my maternal grandmother, Annabelle Gillis and I have always celebrated my birthday on July 1st of each year and in the belief that I was born July 1, 1924

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