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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600988

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rex CharlesSmith Sex Male

Date of Birth July 28, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Loraine Otto Smith MAIDEN NAME of Mother Lena Maud Baldwin

Residence of Father when child was born 24 Smith Street, Halifax Present address of Father 17 Church Street, Halifax

Occupation of Father at Birth of child Tram Operator Place of birth of Father Lunenburg

Race Canadian Name and present address of Physician in attendance at birth

Signature of Applicant Loraine Otto Smith Address of Applicant 17 Church Street, Halifax Date 21 October 1938

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rex CharlesSmith

Born at Halifax in the County of Halifax

That Rex CharlesSmith Whose Birth is sought to be registered was

born at Halifax Halifax County on July 28, 1920

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

That Rex Charles Smith was born at Halifax, July 28, 1920. I am his father.

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