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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500190

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Edward WalterColpitts Sex Male

Date of Birth December 25, 1919 Place of Birth AmherstCounty of Cumberland

Name of Father Howard Colpitts MAIDEN NAME of Mother Edith Weatherbie

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

Residence of Father when child was born Amherst Present address of Father 58 Lower Victoria St.

Occupation of Father at Birth of child Cabinet maker Place of birth of Father Moncton, NB

Race Name and present address of Physician in attendance at birth Dr. Walter T. Purdy

Signature of Applicant Howard Colpitts Address of Applicant 58 Lower Victoria St., Amherst Date 11 January 1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Edward WalterColpitts

Born at Amherst in the County of Cumberland

That Edward WalterColpitts Whose Birth is sought to be registered was

born at Amherst Cumberland County on December 25, 1919

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

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