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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000627

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clifford CalvinBurrows Sex

Date of Birth February 16, 1920 Place of Birth Green OaksCounty of Colchester

Name of Father Percy Burrows MAIDEN NAME of Mother Bessie Henderson

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

Residence of Father when child was born Green Oaks Present address of Father R.r. #1, Truro

Occupation of Father at Birth of child Farming Place of birth of Father Colchester Co.

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

Signature of Applicant Lloyd Burrows Address of Applicant P.O. Box 251, Bedford Date March 8, 1973

Relationship of Applicant to child son of Clifford

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clifford CalvinBurrows

Born at Green Oaks in the County of Colchester

That Clifford CalvinBurrows Whose Birth is sought to be registered was

born at Green Oaks Colchester County on February 16, 1920

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

Certificate of Baptism

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