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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000440

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Fred LionelManthorne Sex Male

Date of Birth June 17, 1920 Place of Birth MiltonCounty of Queens

Name of Father Samuel Manthorne MAIDEN NAME of Mother Ethel McCoombs

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

Residence of Father when child was born Milton Present address of Father Dead

Occupation of Father at Birth of child Labourer Place of birth of Father Milton

Race English Name and present address of Physician in attendance at birth J.W. Smith, Liverpool

Signature of Applicant Ethel Manthorne Address of Applicant Milton Date February 9, 1966

Relationship of Applicant to child same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Fred LionelManthorne

Born at Milton in the County of Queens

That Fred LionelManthorne Whose Birth is sought to be registered was

born at Milton Queens County on June 17, 1920

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

Told me by parents

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