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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000249

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Eric West Sex Male

Date of Birth April 28, 1920 Place of Birth DartmouthCounty of Halifax

Name of Father Frederick William John West MAIDEN NAME of Mother Mary Nichols

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

Residence of Father when child was born Dartmouth Present address of Father Langford Stn, Vancouver Island B.C.

Occupation of Father at Birth of child Shoemaker Place of birth of Father England

Race English Name and present address of Physician in attendance at birth [Taing Heits ]

Signature of Applicant Eric West Address of Applicant Grierlack, Alta. Date January 23, 1956

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Eric West

Born at Dartmouth in the County of Halifax

That Eric West Whose Birth is sought to be registered was

born at Dartmouth Halifax County on April 28, 1920

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

Mother, Certificate of Baptism, School Records

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