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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200036

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kenneth NilesStillman Sex Male

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

Name of Father Niles Stillman MAIDEN NAME of Mother Mary Elizabeth Rule

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

Residence of Father when child was born Sacket Harbour, NY, USA Present address of Father

Occupation of Father at Birth of child Farmer Place of birth of Father Wisconsin, USA

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

Signature of Applicant S.A. Barrington Address of Applicant Halifax Infants' Home Date 09 October 1919

Relationship of Applicant to child nurse present at birth

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kenneth NilesStillman

Born at Halifax in the County of Halifax

That Kenneth NilesStillman 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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