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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000458

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Everett GermaineSelig Sex Male

Date of Birth December 21, 1920 Place of Birth East CliffordCounty of Lunenburg

Name of Father Leo Aubrey Selig MAIDEN NAME of Mother Lalia May Ells

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

Residence of Father when child was born East Clifford Present address of Father East Clifford

Occupation of Father at Birth of child Labourer Place of birth of Father Baker Settlement

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

Signature of Applicant Everett Germaine Selig Address of Applicant Baker Settlement Date December 30, 1967

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Everett GermaineSelig

Born at East Clifford in the County of Lunenburg

That Everett GermaineSelig Whose Birth is sought to be registered was

born at East Clifford Lunenburg County on December 21, 1920

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

Advice of my parents, confirmed by Baptismal Certificate

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