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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200038

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

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

Name of Father Roland J. Beazley MAIDEN NAME of Mother Margaurite Murphy

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

Residence of Father when child was born Halifax Present address of Father 116 Duncan St.

Occupation of Father at Birth of child Grocery clerk Place of birth of Father Herring Cove

Race Name and present address of Physician in attendance at birth A.J. Mader

Signature of Applicant Roland G. Beazley Address of Applicant 116 Duncan Street Date 22 October 1919

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Halifax in the County of Halifax

That Kenneth MatthewBeazley 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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