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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93401431

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Vernon OscarHines Sex Male

Date of Birth June 17, 1906 Place of Birth CarletonCounty of Yarmouth

Name of Father Richard Claud Hines MAIDEN NAME of Mother Maude 

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

Occupation of Father at Birth of child Going to sea Place of birth of Father Pubnico Harbour

Race English Name and present address of Physician in attendance at birth W.A. Morse

Signature of Applicant Richard Claud Hines Address of Applicant Carleton Date 23 February 1926

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Vernon OscarHines

Born at Carleton in the County of Yarmouth

That Vernon OscarHines Whose Birth is sought to be registered was

born at Carleton Yarmouth County on June 17, 1906

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

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