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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100334

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Willard RoyMitchell Sex Male

Date of Birth November 21, 1920 Place of Birth ColdbrookCounty of Kings

Name of Father Raymond Harold Mitchell MAIDEN NAME of Mother  McLellan

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father North Alton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Willard Roy Mitchell Address of Applicant Coldbrook Date November 16, 1984

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Willard RoyMitchell

Born at Coldbrook in the County of Kings

That Willard RoyMitchell Whose Birth is sought to be registered was

born at Coldbrook Kings County on November 21, 1920

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

I am a sister to Mr. Willard Roy Mitchell and have knowledge of his birth. - Evelyn Best

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