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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000745

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Perley NobleTaylor Sex Male

Date of Birth June 11, 1920 Place of Birth RocklandCounty of Kings

Name of Father Noble  Taylor MAIDEN NAME of Mother Blanche  Lutz

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

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Perley N. Taylor Address of Applicant Waterville Date August 25, 1975

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Perley NobleTaylor

Born at Rockland in the County of Kings

That Perley NobleTaylor Whose Birth is sought to be registered was

born at Rockland Kings County on June 11, 1920

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

Common family knowledge, Bible record (see certificate attached), also record from school register attached hereto.

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