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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500209

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Avard SarreJohnson Sex Male

Date of Birth December 28, 1919 Place of Birth Little RiverCounty of Cumberland

Name of Father Howard Avard Johnson MAIDEN NAME of Mother Margaret Jessie Forbes

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

Residence of Father when child was born Little River Present address of Father

Occupation of Father at Birth of child Farmer Place of birth of Father Little River

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

Signature of Applicant Howard Avard Johnson Address of Applicant Oxford Date 15 January 1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Avard SarreJohnson

Born at Little River in the County of Cumberland

That Avard SarreJohnson Whose Birth is sought to be registered was

born at Little River Cumberland County on December 28, 1919

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

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