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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000034

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Keith LawrenceWolfe Sex Male

Date of Birth January 13, 1921 Place of Birth Murray SidingCounty of Colchester

Name of Father Lawrence Alton Wolfe MAIDEN NAME of Mother Inez Pearl Clattenburg

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Murray Siding Present address of Father

Occupation of Father at Birth of child Labourer Place of birth of Father La Have

Race Canadian Name and present address of Physician in attendance at birth Dr. Eaton

Signature of Applicant Blanche Opel Clattenburg Address of Applicant Great Village Date June 20, 1946

Relationship of Applicant to child Grandmother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Keith LawrenceWolfe

Born at Murray Siding in the County of Colchester

That Keith LawrenceWolfe Whose Birth is sought to be registered was

born at Murray Siding Colchester County on January 13, 1921

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

Said child was born at my home.

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