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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000102

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ernest StanleyMiller Sex Male

Date of Birth December 6, 1920 Place of Birth Folly LakeCounty of Colchester

Name of Father Arthur Miller MAIDEN NAME of Mother Elizabeth Rushton

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

Residence of Father when child was born Folly Lake Present address of Father Dead

Occupation of Father at Birth of child Wood working factory Place of birth of Father Oxford

Race White Name and present address of Physician in attendance at birth Deceased

Signature of Applicant Elizabeth Miller Address of Applicant Londonderry Date September 30, 1948

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ernest StanleyMiller

Born at Folly Lake in the County of Colchester

That Ernest StanleyMiller Whose Birth is sought to be registered was

born at Folly Lake Colchester County on December 6, 1920

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

I am his mother

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