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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000516

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harry GeorgeBeck Sex Male

Date of Birth June 10, 1920 Place of Birth BridgewaterCounty of Lunenburg

Name of Father Hughie Roland Beck MAIDEN NAME of Mother Alice Emma Beck

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

Residence of Father when child was born Bridgewater Present address of Father Dead

Occupation of Father at Birth of child Butcher Place of birth of Father Bridgewater

Race Canadian Name and present address of Physician in attendance at birth Dr. Rafuse, dead

Signature of Applicant Harry George Beck Address of Applicant Bridgewater Date June 9, 1970

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harry GeorgeBeck

Born at Bridgewater in the County of Lunenburg

That Harry GeorgeBeck Whose Birth is sought to be registered was

born at Bridgewater Lunenburg County on June 10, 1920

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

Personal Knowledge

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