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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93401323

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Hartley WilfordCrowell Sex Male

Date of Birth January 4, 1906 Place of Birth Clarks HarbourCounty of Shelburne

Name of Father David Howard Crowell MAIDEN NAME of Mother Nettie Swim

Residence of Father when child was born Clarks Harbour Present address of Father Boston

Occupation of Father at Birth of child Fisherman Place of birth of Father Clarks Harbour

Race Canadian Name and present address of Physician in attendance at birth Dr. George W. Brown

Signature of Applicant Nettie Crowell Address of Applicant Clarks Harbour Date 9 February 1926

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Hartley WilfordCrowell

Born at Clarks Harbour in the County of Shelburne

That Hartley WilfordCrowell Whose Birth is sought to be registered was

born at Clarks Harbour Shelburne County on January 4, 1906

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

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