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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000664

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth August 15, 1920 Place of Birth WyvernCounty of Cumberland

Name of Father David William Adshade MAIDEN NAME of Mother Frances MacLeod

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

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

Occupation of Father at Birth of child Labourer Place of birth of Father Mansfield

Race Canadian Name and present address of Physician in attendance at birth Dr. Salter, Oxford, deceased

Signature of Applicant Douglas Adshade Address of Applicant Brantford, Ontario Date December 13, 1973

Relationship of Applicant to child

AFFIDAVIT

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

Born at Wyvern in the County of Cumberland

That George DouglasAdshade Whose Birth is sought to be registered was

born at Wyvern Cumberland County on August 15, 1920

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

That I am the brother of the said George Douglas Adshade being born on the 15th day of August, 1920 and a record of his birth is recorded in the Family Bible on the same page as my own date of birth which was November 21, 1924. That I resided with the said George Douglas Adshade and knew him to be my older brother by approximately four years. - Robert Gerald Adshade

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