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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000468

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John VernonBarker Sex Male

Date of Birth May 21, 1920 Place of Birth Forest GladeCounty of Annapolis

Name of Father Vernon Barker MAIDEN NAME of Mother Sadie Lyon

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

Residence of Father when child was born Forest Glade Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Forest Glade

Race English Name and present address of Physician in attendance at birth Deceased

Signature of Applicant John Vernon Baker Address of Applicant Date March 16, 1968

Relationship of Applicant to child same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John VernonBarker

Born at Forest Glade in the County of Annapolis

That John VernonBarker Whose Birth is sought to be registered was

born at Forest Glade Annapolis County on May 21, 1920

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

Please see statement found in records in High School where school records are preserved

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