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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500098

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Richard WilliamAndres Sex Male

Date of Birth November 29, 1919 Place of Birth AmherstCounty of Cumberland

Name of Father Blair William Andres MAIDEN NAME of Mother Gertrude Smith

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

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

Occupation of Father at Birth of child Clerk Place of birth of Father Amherst

Race Name and present address of Physician in attendance at birth Dr. B.E. Goodwin

Signature of Applicant Gertrude Andres Address of Applicant Amherst Date 10 January 1920

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Richard WilliamAndres

Born at Amherst in the County of Cumberland

That Richard WilliamAndres Whose Birth is sought to be registered was

born at Amherst Cumberland County on November 29, 1919

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

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