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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

10000100

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorance LeonardMatheson Sex Male

Date of Birth September 30, 1919 Place of Birth AmherstCounty of Cumberland

Name of Father Gordon Farnell Matheson MAIDEN NAME of Mother Hilda May Cooke

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

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

Occupation of Father at Birth of child Miner Place of birth of Father Maccon

Race Name and present address of Physician in attendance at birth Dr. Miller

Signature of Applicant Hilda Matherson Address of Applicant Maccon Date 12 January 1920

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorance LeonardMatheson

Born at Amherst in the County of Cumberland

That Dorance LeonardMatheson Whose Birth is sought to be registered was

born at Amherst Cumberland County on September 30, 1919

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

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