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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000720

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Levi JosiahHorne Sex Male

Date of Birth October 4, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Thomas George Horne MAIDEN NAME of Mother Viola Beatrice Tutty

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

Residence of Father when child was born Horne's Road, Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Sydney, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Levi J. Horne Address of Applicant Meadows Road, RR #1, Sydney Forks, Cape Breton Co., NS Date 20 August 1981

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Levi JosiahHorne

Born at Sydney in the County of Cape Breton

That Levi JosiahHorne Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 4, 1924

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

Certificate of Baptism, which is enclosed Certificate of marriage, enclosed Surname Horne confirmed from parents marriage

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