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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700086

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of LenardSimms Sex Male

Date of Birth December 12, 1919 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father Emanuel Simms MAIDEN NAME of Mother Sarah Bell Jackson

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

Residence of Father when child was born Sydney Mines Present address of Father Prince St.

Occupation of Father at Birth of child Miner Place of birth of Father Newfoundland

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

Signature of Applicant Emanuel Sims Address of Applicant Prince St. Sydney Mines Date 23 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of LenardSimms

Born at Sydney Mines in the County of Cape Breton

That LenardSimms Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on December 12, 1919

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

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