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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000378

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bradford ElliottAvery Sex

Date of Birth May 21, 1920 Place of Birth Port WilliamsCounty of Kings

Name of Father Arthur James  Avery MAIDEN NAME of Mother Annie Reece

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

Residence of Father when child was born Port Williams Present address of Father deceased

Occupation of Father at Birth of child Farm Labourer Place of birth of Father Avonport

Race English Name and present address of Physician in attendance at birth Dr. Elliott, Deceased

Signature of Applicant Adena P. Goodwin Address of Applicant Lr. Argyle Date January 15,

Relationship of Applicant to child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bradford ElliottAvery

Born at Port Williams in the County of Kings

That Bradford ElliottAvery Whose Birth is sought to be registered was

born at Port Williams Kings County on May 21, 1920

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

Recall birth of brother, who is six years younger than myself. Information received from parents.

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