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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000283

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Leroy EllotAcker Sex

Date of Birth March 4, 1920 Place of Birth Hunters LodgeCounty of Annapolis

Name of Father James Frederick Acker MAIDEN NAME of Mother Ida Agnes Goucher

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

Residence of Father when child was born Hunters Lodge Present address of Father Caledonia, Queens County

Occupation of Father at Birth of child Laborer Place of birth of Father Hunters Lodge

Race Anglo-Saxon Name and present address of Physician in attendance at birth Mrs. Sedilia Goucher, Midwife

Signature of Applicant Ida Agnes Acker Address of Applicant Caledonia, Queens County Date October 8, 1957

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Leroy EllotAcker

Born at Hunters Lodge in the County of Annapolis

That Leroy EllotAcker Whose Birth is sought to be registered was

born at Hunters Lodge Annapolis County on March 4, 1920

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

I am his mother and have a record of the births of all my family and the name of my son Leroy Ellot Acker appears thereon (together with all others of my family) as being born March 4th, 1920.

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