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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000495

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of George RobertDavis Sex Male

Date of Birth September 23, 1920 Place of Birth AmherstCounty of Cumberland

Name of Father Herbert Edwin Davis MAIDEN NAME of Mother Minnie Maud Lee

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

Residence of Father when child was born Amherst Present address of Father Amherst

Occupation of Father at Birth of child Clerk Place of birth of Father Shemogue, New Brunswick

Race English Name and present address of Physician in attendance at birth Dr. F.E. Boudreau, Moncton, New Brunswick

Signature of Applicant H.E. Davis Address of Applicant Amherst Date April 6, 1948

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of George RobertDavis

Born at Amherst in the County of Cumberland

That George RobertDavis Whose Birth is sought to be registered was

born at Amherst Cumberland County on September 23, 1920

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

I, Herbert E. Davis, father of George Robert Davis, was present at his birth on the 23rd of September 1920, at Amherst, Cumberland county. Note: Since filling in upper part of this form I have moved to Ottawa.

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