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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200459

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Herbert AlfredPalmer Sex Male

Date of Birth December 24, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Francis Henry Palmer MAIDEN NAME of Mother Beatrice May Dean

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

Residence of Father when child was born Halifax Present address of Father 1 Churchfield

Occupation of Father at Birth of child Soldier Place of birth of Father London, England

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

Signature of Applicant Francis Henry Palmer Address of Applicant 1 Churchfield Date 30 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Herbert AlfredPalmer

Born at Halifax in the County of Halifax

That Herbert AlfredPalmer Whose Birth is sought to be registered was

born at Halifax Halifax County on December 24, 1919

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

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