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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000270

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Elmer Lavaughan David Sex

Date of Birth September 14, 1920 Place of Birth Hammonds PlainsCounty of Halifax

Name of Father Arthur David MAIDEN NAME of Mother Floretta Mitchell

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

Residence of Father when child was born Hammonds Plains Present address of Father Yarmouth

Occupation of Father at Birth of child Labourer Place of birth of Father Hammonds Plains

Race Canadian Name and present address of Physician in attendance at birth Midwife - Mrs. Joseph Davis (Deceased)

Signature of Applicant E.L. David Address of Applicant Yarmouth Date May 19, 1956

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Elmer Lavaughan David

Born at Hammonds Plains in the County of Halifax

That Elmer Lavaughan David Whose Birth is sought to be registered was

born at Hammonds Plains Halifax County on September 14, 1920

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

I am the father of the above child and know these facts to be true.

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