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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700609

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of David Albert AltonRomans Sex Male

Date of Birth November 27, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father David J. Romans MAIDEN NAME of Mother Rachel Ley

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

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

Occupation of Father at Birth of child Postal clerk Place of birth of Father West Roxbury, Mass.

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

Signature of Applicant Rachel L. Romans Address of Applicant Halifax Date 11 May 1931

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of David Albert AltonRomans

Born at Glace Bay in the County of Cape Breton

That David Albert AltonRomans Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on November 27, 1919

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

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