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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100129

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of GordonRiley Sex

Date of Birth September 9, 1920 Place of Birth Cherry BrookCounty of Halifax

Name of Father Arthur  Riley MAIDEN NAME of Mother Lena Cain

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

Residence of Father when child was born Cherry Brook Present address of Father deceased

Occupation of Father at Birth of child Laborer Place of birth of Father Cherry Brook

Race Name and present address of Physician in attendance at birth

Signature of Applicant Gordon Riley Address of Applicant Sarah Clayton Manor, Apt. 7, East Preston Date June 18, 1981

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of GordonRiley

Born at Cherry Brook in the County of Halifax

That GordonRiley Whose Birth is sought to be registered was

born at Cherry Brook Halifax County on September 9, 1920

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

A letter received from the Deputy Registrar General of Nova Scotia dated June 3, 1981. Census, National Registration.

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