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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000963

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of George RobertCoffie Sex Male

Date of Birth July 2, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Benjamin Coffie MAIDEN NAME of Mother Clare MacPhee

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

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father St. Pierre and Miquelon

Race Name and present address of Physician in attendance at birth

Signature of Applicant George R. Coffie Address of Applicant 1623 Magenta Court, Missasauga, Ontario Date May 30, 1940

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of George RobertCoffie

Born at Sydney in the County of Cape Breton

That George RobertCoffie Whose Birth is sought to be registered was

born at Sydney Cape Breton County on July 2, 1924

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

I have known the individual for over 20 years present documents supplied. Baptism and marriage extract

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