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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93501511

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth January 13, 1906 Place of Birth StellartonCounty of Pictou

Name of Father William Brooks MAIDEN NAME of Mother Annie Kennedy

Residence of Father when child was born Stellarton Present address of Father Glace Bay

Occupation of Father at Birth of child Coal Miner Place of birth of Father England

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

Signature of Applicant William Brooks Address of Applicant Glace Bay Date 20 March 1926

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Stellarton in the County of Pictou

That RolandBrooks Whose Birth is sought to be registered was

born at Stellarton Pictou County on January 13, 1906

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

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