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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200261

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gorden StanleyMont Sex Male

Date of Birth November 17, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Harry Fletcher Mont MAIDEN NAME of Mother Helen Moss

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

Residence of Father when child was born Halifax Present address of Father 81 Creighton Ave.

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

Race Name and present address of Physician in attendance at birth Mrs. Kelly

Signature of Applicant Harry Fletcher Mont Address of Applicant 81 Creighton Ave. Date 20 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gorden StanleyMont

Born at Halifax in the County of Halifax

That Gorden StanleyMont Whose Birth is sought to be registered was

born at Halifax Halifax County on November 17, 1919

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

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