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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000483

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth March 10, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father John F.  Shephard MAIDEN NAME of Mother Jomina Helena Walsh

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

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

Occupation of Father at Birth of child Construction Worker Place of birth of Father Charlottetown, Prince Edward Island

Race English Name and present address of Physician in attendance at birth Dr. Norman MacKey

Signature of Applicant John R.E. Shephard Address of Applicant Prince Edward Island Date September 11, 1968

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John Richard GarfieldShephard

Born at Halifax in the County of Halifax

That John Richard GarfieldShephard Whose Birth is sought to be registered was

born at Halifax Halifax County on March 10, 1920

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

Baptism Certificate

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