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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92000832

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William RomelyJohnston Sex

Date of Birth February 9, 1920 Place of Birth Cherry BrookCounty of Halifax

Name of Father William Johnston MAIDEN NAME of Mother Rebecca Sparks

Residence of Father when child was born Cherry Brook Present address of Father deceased

Occupation of Father at Birth of child Laborer Place of birth of Father

Race Negro Name and present address of Physician in attendance at birth Dartmouth

Signature of Applicant Mrs. Rebecca Bundy Address of Applicant Cherry Brook Date October 20, 1941

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William RomelyJohnston

Born at Cherry Brook in the County of Halifax

That William RomelyJohnston Whose Birth is sought to be registered was

born at Cherry Brook Halifax County on February 9, 1920

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

I am his legal mother.

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