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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93602275

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Laurie EverettSimpson Sex Male

Date of Birth November 19, 1906 Place of Birth AntigonishCounty of Antigonish

Name of Father Frank Everett Simpson MAIDEN NAME of Mother Lola May Taylor

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

Occupation of Father at Birth of child Clerk Place of birth of Father Nova Scotia

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

Signature of Applicant Laurie Everett Simpson Address of Applicant Antigonish Date 21 May 1926

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Laurie EverettSimpson

Born at Antigonish in the County of Antigonish

That Laurie EverettSimpson Whose Birth is sought to be registered was

born at Antigonish Antigonish County on November 19, 1906

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

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