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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200035

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Douglas EdwardDart Sex Male

Date of Birth October 8, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Edward Francis Dart MAIDEN NAME of Mother Gladys Irene Heffernan

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

Residence of Father when child was born Halifax Present address of Father 35 Agricola St.

Occupation of Father at Birth of child Mail clerk Place of birth of Father Halifax

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

Signature of Applicant Edward Dart Address of Applicant 35 Agricola St Date 08 October 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Douglas EdwardDart

Born at Halifax in the County of Halifax

That Douglas EdwardDart Whose Birth is sought to be registered was

born at Halifax Halifax County on October 8, 1919

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

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