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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000299

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James DouglasAnderson Sex Male

Date of Birth August 15, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Lewis Benjamin Anderson MAIDEN NAME of Mother Beatrice Louise Corkum

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

Residence of Father when child was born Halifax Present address of Father deceased

Occupation of Father at Birth of child Shipwright Place of birth of Father Lunenburg

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

Signature of Applicant Beatrice L. Anderson Address of Applicant Lunenburg Date 28 November 1958

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James DouglasAnderson

Born at Halifax in the County of Halifax

That James DouglasAnderson Whose Birth is sought to be registered was

born at Halifax Halifax County on August 15, 1920

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

I am his mother. Certificate of Baptism enclosed

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