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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600573

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Robert BasilDakens Sex Male

Date of Birth September 7, 1920 Place of Birth StellartonCounty of Pictou

Name of Father Joseph Dakens MAIDEN NAME of Mother Catherine Keddy

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

Residence of Father when child was born Stellarton, Pictou Co. Present address of Father Stellarton, Pictou Co.

Occupation of Father at Birth of child Miner Place of birth of Father Stellarton, Pictou Co.

Race English Name and present address of Physician in attendance at birth G. W. Whitman, Stellarton, Pictou Co.

Signature of Applicant Catherine Dakens Address of Applicant Date

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Robert BasilDakens

Born at Stellarton in the County of Pictou

That Robert BasilDakens Whose Birth is sought to be registered was

born at Stellarton Pictou County on September 7, 1920

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

Personal knowledge as mother

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