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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000436

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of George WilliamBurns Sex Male

Date of Birth July 6, 1920 Place of Birth Upper LaHaveCounty of Lunenburg

Name of Father George Edwin Burns MAIDEN NAME of Mother Susan Jane Mahoney

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

Residence of Father when child was born Upper LaHave Present address of Father deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father Upper LaHave

Race Scottish Name and present address of Physician in attendance at birth Dr. Rafuse, deceased

Signature of Applicant Susan J. Burns Address of Applicant Bridgewater Date July 19, 1966

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of George WilliamBurns

Born at Upper LaHave in the County of Lunenburg

That George WilliamBurns Whose Birth is sought to be registered was

born at Upper LaHave Lunenburg County on July 6, 1920

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

recorded in family bible which I have retained, also attended some school and were neighbours at Upper LaHave and attended family get-togethers for supper to celebrate George's birthday

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