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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700129

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Herbert FrancisPoole Sex Male

Date of Birth December 21, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father Frederick Thomas Poole MAIDEN NAME of Mother Caroline Vokey

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

Residence of Father when child was born Glace Bay Present address of Father Newton St.

Occupation of Father at Birth of child Miner Place of birth of Father White Bay, Newfoundland

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

Signature of Applicant Frederick Thomas Poole Address of Applicant Newton St., Glace Bay Date 16 January 1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Herbert FrancisPoole

Born at Glace Bay in the County of Cape Breton

That Herbert FrancisPoole Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 21, 1919

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

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