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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91703260

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Cecil RobertScott Sex Male

Date of Birth August 25, 1920 Place of Birth HantsportCounty of Hants

Name of Father Alexander Scott MAIDEN NAME of Mother Florence Fields

Residence of Father when child was born Hantsport Present address of Father

Occupation of Father at Birth of child Marine fireman Place of birth of Father Glasgow, Scotland, Great Britain

Race White Name and present address of Physician in attendance at birth F. R. Shankle, Windsor

Signature of Applicant Florence Barkhouse Address of Applicant Hantsport, Hants Co. Date 23 January 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Cecil RobertScott

Born at Hantsport in the County of Hants

That Cecil RobertScott Whose Birth is sought to be registered was

born at Hantsport Hants County on August 25, 1920

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

I am the mother of Cecil Robert Scott and well remember the month, date and year of his birth

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