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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000183

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clarence EdwardDorrington Sex Male

Date of Birth February 27, 1920 Place of Birth StellartonCounty of Pictou

Name of Father John Charles Dorrington MAIDEN NAME of Mother Stella Leona Clyburn

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

Residence of Father when child was born Hudson St. Stellarton Present address of Father Stellarton

Occupation of Father at Birth of child Miner Place of birth of Father Guysborough

Race Caucasian Name and present address of Physician in attendance at birth Clarence MacMillan

Signature of Applicant Clarence E. Dorrington Address of Applicant 620 Hudson St. Stellarton Date March 28, 1952

Relationship of Applicant to child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clarence EdwardDorrington

Born at Stellarton in the County of Pictou

That Clarence EdwardDorrington Whose Birth is sought to be registered was

born at Stellarton Pictou County on February 27, 1920

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

I was present at the time of his birth (Census report and school record)

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