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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500129

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John AllenGullon Sex Male

Date of Birth November 21, 1919 Place of Birth WallaceCounty of Cumberland

Name of Father Alexander Cameron Gullon MAIDEN NAME of Mother Annie Vera Patriquin

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

Residence of Father when child was born Upper Malagash Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Upper Malagash

Race Name and present address of Physician in attendance at birth Dr. F.D. Chairman

Signature of Applicant Alexander Cameron Gullon Address of Applicant Malagash Date 22 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John AllenGullon

Born at Wallace in the County of Cumberland

That John AllenGullon Whose Birth is sought to be registered was

born at Wallace Cumberland County on November 21, 1919

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

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