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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000773

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bernard Samuel Sheaves Sex Male

Date of Birth December 25, 1920 Place of Birth DartmouthCounty of Halifax

Name of Father Charles Henry Sheaves MAIDEN NAME of Mother Elizabeth Moran

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

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

Occupation of Father at Birth of child Labourer Place of birth of Father Port-aux-Basque, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant B.S. Sheaves Address of Applicant Dartmouth Date March 25, 1976

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bernard Samuel Sheaves

Born at Dartmouth in the County of Halifax

That Bernard Samuel Sheaves Whose Birth is sought to be registered was

born at Dartmouth Halifax County on December 25, 1920

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

Baptism

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