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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000025

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harold FenwickCampbell Sex Male

Date of Birth November 4, 1920 Place of Birth East WentworthCounty of Cumberland

Name of Father Ivan Muir Campbell MAIDEN NAME of Mother Jessie Mildred Smith

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

Residence of Father when child was born East Wentworth Present address of Father Folly Lake

Occupation of Father at Birth of child Labourer Place of birth of Father Folly Lake

Race Anglo Saxon Name and present address of Physician in attendance at birth Dr. Dan Murray, Tatamagouche

Signature of Applicant Mrs. Ivan M. Campbell Address of Applicant Folly Lake Date November 8, 1946

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harold FenwickCampbell

Born at East Wentworth in the County of Cumberland

That Harold FenwickCampbell Whose Birth is sought to be registered was

born at East Wentworth Cumberland County on November 4, 1920

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

That I am the mother of said Harold Fenwick Campbell

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