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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000073

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth August 27, 1921 Place of Birth TruroCounty of Colchester

Name of Father John Johnson MAIDEN NAME of Mother Mary McDonald

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

Residence of Father when child was born Truro Present address of Father deceased

Occupation of Father at Birth of child Merchant Place of birth of Father Damascus, Syria

Race White Name and present address of Physician in attendance at birth Dr. Dumbar

Signature of Applicant Mrs. Mary Johnson Address of Applicant 1016 Gayeau St. Windsor, Ontario Date February 2, 1948

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Truro in the County of Colchester

That CollinJohnson Whose Birth is sought to be registered was

born at Truro Colchester County on August 27, 1921

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

I am the Mother of the above mentioned Child

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