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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200049

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Norman Sex Male

Date of Birth October 10, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Leverett Horton Norman MAIDEN NAME of Mother Helen Baher Wheadon

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

Residence of Father when child was born Halifax Present address of Father 17 Cogswell

Occupation of Father at Birth of child Restaurant keeper Place of birth of Father West LaHave

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

Signature of Applicant Leverett H. Norman Address of Applicant Date 17 October 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Norman

Born at Halifax in the County of Halifax

That Norman Whose Birth is sought to be registered was

born at Halifax Halifax County on October 10, 1919

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

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