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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100148

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Thomas Frederick K.O'Hearn Sex

Date of Birth March 23, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father James Frederick K. O'Hearn MAIDEN NAME of Mother May Power

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

Residence of Father when child was born Halifax Present address of Father

Occupation of Father at Birth of child CNR Car Foreman Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Grace O'Hearn Address of Applicant 5511 Sebastian Pl, Halifax Date December 7, 1981

Relationship of Applicant to child Wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Thomas Frederick K.O'Hearn

Born at Halifax in the County of Halifax

That Thomas Frederick K.O'Hearn Whose Birth is sought to be registered was

born at Halifax Halifax County on March 23, 1920

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

Marriage Extract Baptismal Cert.

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