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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000018

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Reginald LeoSmith Sex Male

Date of Birth June 12, 1920 Place of Birth OxfordCounty of Cumberland

Name of Father Guy Wellington Smith MAIDEN NAME of Mother Carrie Alwilda Mills

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

Residence of Father when child was born Shinimecas Bridge Present address of Father Shinimecas Bridge

Occupation of Father at Birth of child Farming Place of birth of Father Shinimecas Bridge

Race English Name and present address of Physician in attendance at birth Dr. Salter

Signature of Applicant Mrs. Guy W. Smith Address of Applicant Shinimecas Bridge Date August 12, 1946

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Reginald LeoSmith

Born at Oxford in the County of Cumberland

That Reginald LeoSmith Whose Birth is sought to be registered was

born at Oxford Cumberland County on June 12, 1920

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

As I am his mother

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