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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000067

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Douglas AndrewNorman Sex Male

Date of Birth October 30, 1920 Place of Birth LiverpoolCounty of Queens

Name of Father Andrew O'Leur Norman MAIDEN NAME of Mother Margaret Ryer

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Milton

Race Caucasian Name and present address of Physician in attendance at birth Dr. T.R. Hood M.D.

Signature of Applicant Douglas Norman Address of Applicant Liverpool Date June 24, 1947

Relationship of Applicant to child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Douglas AndrewNorman

Born at Liverpool in the County of Queens

That Douglas AndrewNorman Whose Birth is sought to be registered was

born at Liverpool Queens County on October 30, 1920

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

I am his father and know the date of his birth

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