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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90501791

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clifford EdwinLloy Sex Male

Date of Birth February 17, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Edgar Innis Lloy MAIDEN NAME of Mother Mary Belle Burr

Residence of Father when child was born 66 Cedar Street, Halifax Present address of Father Gladstone, Manitoba

Occupation of Father at Birth of child Farmer Place of birth of Father Lawrencetown, Halifax Co.

Race Welsh Name and present address of Physician in attendance at birth Dr. L. S. Morton, 52 Spring Garden Road, Halifax

Signature of Applicant Edgar Lloy Address of Applicant Gladstone, Manitoba Date 6 February 1941

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clifford EdwinLloy

Born at Halifax in the County of Halifax

That Clifford EdwinLloy Whose Birth is sought to be registered was

born at Halifax Halifax County on February 17, 1920

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

was present in the house at time of birth

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