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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200160

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ivan LeRoyNicoll Sex Male

Date of Birth October 29, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Frederick William Morley Nicoll MAIDEN NAME of Mother Dorothy Allen Nickerson

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

Residence of Father when child was born Halifax Present address of Father 39 Cunard St.

Occupation of Father at Birth of child Clerk Place of birth of Father Halifax

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

Signature of Applicant Frederick William Morley Nicoll Address of Applicant 39 Cunard St. Date 06 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ivan LeRoyNicoll

Born at Halifax in the County of Halifax

That Ivan LeRoyNicoll Whose Birth is sought to be registered was

born at Halifax Halifax County on October 29, 1919

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

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