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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200054

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James WilliamBlackstock Sex Male

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

Name of Father John Blackstock MAIDEN NAME of Mother Elizabeth Coulten

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

Residence of Father when child was born Halifax Present address of Father 60 MacDonald St.

Occupation of Father at Birth of child Riveter Place of birth of Father Glasgow, Scotland

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

Signature of Applicant Elizabeth Blackstock Address of Applicant 60 MacDonald St. Date 03 November 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James WilliamBlackstock

Born at Halifax in the County of Halifax

That James WilliamBlackstock 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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