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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000443

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Thomas CarlyleWheeler Sex Male

Date of Birth July 6, 1920 Place of Birth YarmouthCounty of Yarmouth

Name of Father John Lewis Wheeler MAIDEN NAME of Mother Mariam Cecilia Stephens

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

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

Occupation of Father at Birth of child Chef-hotel Place of birth of Father Gloucester, Massachusetts

Race German Name and present address of Physician in attendance at birth Dr. Harris

Signature of Applicant Thomas Wheeler Address of Applicant Shearwater Date April 11, 1967

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Thomas CarlyleWheeler

Born at Yarmouth in the County of Yarmouth

That Thomas CarlyleWheeler Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on July 6, 1920

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

Information heard from parents Bible record National Registration Record

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