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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100086

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bertram LewisHolmes Sex Female

Date of Birth March 17, 1920 Place of Birth Sandy PointCounty of Shelburne

Name of Father George Wellington Holmes MAIDEN NAME of Mother  Goodick

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

Residence of Father when child was born Sandy Point, Shelburne Co. Present address of Father deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Sandy Point, Shelburne Co.

Race Name and present address of Physician in attendance at birth

Signature of Applicant Bertram Lewis Holmes Address of Applicant Sandy Point, Shelburne Co. Date 30 August 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bertram LewisHolmes

Born at Sandy Point in the County of Shelburne

That Bertram LewisHolmes Whose Birth is sought to be registered was

born at Sandy Point Shelburne County on March 17, 1920

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

I am the older brother of Bertram Lewis Holmes and have personal knowledge of the date of his birth.

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