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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000749

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gerald FrederickMartin Sex Male

Date of Birth July 14, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Clara Martin

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant G. Martin Address of Applicant Digby Date October 23, 1975

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gerald FrederickMartin

Born at Halifax in the County of Halifax

That Gerald FrederickMartin Whose Birth is sought to be registered was

born at Halifax Halifax County on July 14, 1920

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

Baptismal Certificate Statutory Declaration

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