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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200385

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Walter GordonMacCumber Sex Male

Date of Birth December 11, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father William MacCumber MAIDEN NAME of Mother Gladys Kate Roberts

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

Residence of Father when child was born Halifax Present address of Father 70 Coburg Rd.

Occupation of Father at Birth of child Sailor Place of birth of Father Great Falls, Montana, USA

Race Name and present address of Physician in attendance at birth Dr. A.J. Mader

Signature of Applicant William MacCumber Address of Applicant 70 Coburg Rd. Date 22 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Walter GordonMacCumber

Born at Halifax in the County of Halifax

That Walter GordonMacCumber Whose Birth is sought to be registered was

born at Halifax Halifax County on December 11, 1919

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

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