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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700374

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth November 2, 1919 Place of Birth FlorenceCounty of Cape Breton

Name of Father George Snow MAIDEN NAME of Mother Mary Ann Hall

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

Residence of Father when child was born Florence Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Sydney Mines

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

Signature of Applicant George Snow Address of Applicant Florence Date 10 November 1919

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Florence in the County of Cape Breton

That SamuelSnow Whose Birth is sought to be registered was

born at Florence Cape Breton County on November 2, 1919

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

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