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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000390

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Earl ElijahRoss Sex Male

Date of Birth April 17, 1920 Place of Birth NewportCounty of Hants

Name of Father Melvin Fraser Ross MAIDEN NAME of Mother Agnes May Brown

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

Residence of Father when child was born Newport, Hants Co. Present address of Father Newport, Hants Co.

Occupation of Father at Birth of child Farmer Place of birth of Father Cheverie, Hants Co.

Race Scottish Name and present address of Physician in attendance at birth R. R. Reid, M.D.

Signature of Applicant Agnes May Ross Address of Applicant Newport, Hants Co. Date 29 November 1920

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Earl ElijahRoss

Born at Newport in the County of Hants

That Earl ElijahRoss Whose Birth is sought to be registered was

born at Newport Hants County on April 17, 1920

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

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