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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000282

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Burton LeroySanford Sex Male

Date of Birth January 22, 1920 Place of Birth CheverieCounty of Hants

Name of Father Daniel Edson Sanford MAIDEN NAME of Mother Verlie Lillian Weatherbee

Residence of Father when child was born Cheverie Present address of Father

Occupation of Father at Birth of child Farmer Place of birth of Father Centre Burlington

Race English Name and present address of Physician in attendance at birth Dr. A Hines

Signature of Applicant Address of Applicant Date January 24, 1920

Relationship of Applicant to child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Burton LeroySanford

Born at Cheverie in the County of Hants

That Burton LeroySanford Whose Birth is sought to be registered was

born at Cheverie Hants County on January 22, 1920

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

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