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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000738

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Aubrey LewisCrouse Sex Male

Date of Birth May 18, 1920 Place of Birth ChelseaCounty of Lunenburg

Name of Father Elizah Crouse MAIDEN NAME of Mother Annie [Smith]

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father Chelsea

Race Name and present address of Physician in attendance at birth

Signature of Applicant Maynard Smith Address of Applicant Pleasantville Date July 7, 1975

Relationship of Applicant to child uncle

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Aubrey LewisCrouse

Born at Chelsea in the County of Lunenburg

That Aubrey LewisCrouse Whose Birth is sought to be registered was

born at Chelsea Lunenburg County on May 18, 1920

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

School Records and census reports

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