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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000869

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of ThomasCapstick Sex Male

Date of Birth February 14, 1924 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father Thomas J. Capstick MAIDEN NAME of Mother Margaret Fraser

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

Residence of Father when child was born Ocean St. Sydney Mines Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Thomas MacDougall Address of Applicant 23 Inverary Dr. Dartmouth Date July 6, 1987

Relationship of Applicant to child Newphew

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of ThomasCapstick

Born at Sydney Mines in the County of Cape Breton

That ThomasCapstick Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on February 14, 1924

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

(1) School record (2) Dr.'s record

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