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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200478

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harry EdwardPottie Sex Male

Date of Birth December 26, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Frank Pottie MAIDEN NAME of Mother Eva Mombourquette

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

Residence of Father when child was born Halifax Present address of Father 10 Salter St.

Occupation of Father at Birth of child Labourer Place of birth of Father L'Ardoise

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

Signature of Applicant Frank Pottie Address of Applicant 10 Salter St. Date 15 February1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harry EdwardPottie

Born at Halifax in the County of Halifax

That Harry EdwardPottie Whose Birth is sought to be registered was

born at Halifax Halifax County on December 26, 1919

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

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