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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500066

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Amos LeonardBoss Sex Male

Date of Birth October 19, 1919 Place of Birth SpringhillCounty of Cumberland

Name of Father Amos Boss MAIDEN NAME of Mother Laura Young

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

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

Occupation of Father at Birth of child Coal miner Place of birth of Father River Philip

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

Signature of Applicant Laura Boss Address of Applicant Springhill Date 07 November 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Amos LeonardBoss

Born at Springhill in the County of Cumberland

That Amos LeonardBoss Whose Birth is sought to be registered was

born at Springhill Cumberland County on October 19, 1919

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

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