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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000086

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Earl KitchenerWilliams Sex Male

Date of Birth April 12, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Levi Williams MAIDEN NAME of Mother Mary Ann Rockwood

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

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

Occupation of Father at Birth of child Shipwright Place of birth of Father Newfoundland

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

Signature of Applicant Levi Williams Address of Applicant 64 Agricola St. Halifax Date February 4, 1948

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Earl KitchenerWilliams

Born at Halifax in the County of Halifax

That Earl KitchenerWilliams Whose Birth is sought to be registered was

born at Halifax Halifax County on April 12, 1921

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

That I am his Father and have his birth recorded in the Family Bible.

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