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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000232

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clifford MiltonVanNorden Sex Male

Date of Birth April 10, 1920 Place of Birth LiverpoolCounty of Queens

Name of Father George Herman VanNorden MAIDEN NAME of Mother Agnes Louise Feener

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

Residence of Father when child was born Liverpool, Queens Co. Present address of Father Liverpool, Queens Co.

Occupation of Father at Birth of child Railway Man Place of birth of Father Nova Scotia

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

Signature of Applicant Agnes Louise VanNorden Address of Applicant Liverpool, Queens Co. Date 24 September 1955

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clifford MiltonVanNorden

Born at Liverpool in the County of Queens

That Clifford MiltonVanNorden Whose Birth is sought to be registered was

born at Liverpool Queens County on April 10, 1920

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

I am his mother and well remember the event, and the record referred in the Magistrates certificate is the original one made of our family. (Army records and family records)

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