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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93602165

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Norman SimonRogers Sex Male

Date of Birth August 6, 1906 Place of Birth HeathertonCounty of Antigonish

Name of Father Arthur H. Rogers MAIDEN NAME of Mother Mary Ann Pero

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

Occupation of Father at Birth of child Farmer Place of birth of Father Heatherton

Race white Name and present address of Physician in attendance at birth

Signature of Applicant Norman Simon Rogers Address of Applicant Heatheron Date 25 February 1926

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Norman SimonRogers

Born at Heatherton in the County of Antigonish

That Norman SimonRogers Whose Birth is sought to be registered was

born at Heatherton Antigonish County on August 6, 1906

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

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