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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500032

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Eric ThorntonChapman Sex Male

Date of Birth October 18, 1919 Place of Birth East AmherstCounty of Cumberland

Name of Father Elmer Dousit Chapman MAIDEN NAME of Mother Lottie Belle Wells

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

Residence of Father when child was born Truemanville Present address of Father

Occupation of Father at Birth of child Lumbering Place of birth of Father Chapman Settlement

Race Name and present address of Physician in attendance at birth Dr. E.P. Atkinson

Signature of Applicant Elmer Dousit Chapman Address of Applicant Truemanville, NS Date 12 January 1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Eric ThorntonChapman

Born at East Amherst in the County of Cumberland

That Eric ThorntonChapman Whose Birth is sought to be registered was

born at East Amherst Cumberland County on October 18, 1919

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

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