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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200116

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Donald HarrySimpkin Sex Male

Date of Birth October 23, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Harry Simpkin MAIDEN NAME of Mother Mary Ethel Dauphinee

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

Residence of Father when child was born Halifax Present address of Father 115 Maynard Street

Occupation of Father at Birth of child Engineer Place of birth of Father Yorkshire, England

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

Signature of Applicant Harry Simpkin Address of Applicant 115 Maynard St. Date 23 October 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Donald HarrySimpkin

Born at Halifax in the County of Halifax

That Donald HarrySimpkin Whose Birth is sought to be registered was

born at Halifax Halifax County on October 23, 1919

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

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