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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100414

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Francis AugustusHenneberry Sex Male

Date of Birth July 10, 1920 Place of Birth SambroCounty of Halifax

Name of Father Augustus Henneberry MAIDEN NAME of Mother Helena Twohig

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

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

Occupation of Father at Birth of child Place of birth of Father Sambro

Race Name and present address of Physician in attendance at birth

Signature of Applicant Margaret Henneberry Address of Applicant Sambro Date September 10, 2002

Relationship of Applicant to child wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Francis AugustusHenneberry

Born at Sambro in the County of Halifax

That Francis AugustusHenneberry Whose Birth is sought to be registered was

born at Sambro Halifax County on July 10, 1920

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

Baptism Certificate and Marriage Certificate

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