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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000879

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Cecelia LouiseCusack Sex Female

Date of Birth May 12, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Michael Cusack MAIDEN NAME of Mother Margaret Hines

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

Residence of Father when child was born 480 Prince St. Sydney Present address of Father deceased

Occupation of Father at Birth of child Coal Trimmer, Dominion Coal Co. Place of birth of Father South Bar

Race Name and present address of Physician in attendance at birth

Signature of Applicant Cecelia Louis Coffin Address of Applicant 58 Sutherland St. Sydney Date August 20, 1987

Relationship of Applicant to child n/a

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Cecelia LouiseCusack

Born at Sydney in the County of Cape Breton

That Cecelia LouiseCusack Whose Birth is sought to be registered was

born at Sydney Cape Breton County on May 12, 1924

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

That I was a personal friend and neighbor of the Cusack fmaily at the time of the birth

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