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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000130

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Robert LeslieCole Sex Male

Date of Birth September 6, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Sadie I. Burgwin

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

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

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

Signature of Applicant Saide I. Cole Address of Applicant Green Rd. Armdale Date October 30, 1950

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Robert LeslieCole

Born at Halifax in the County of Halifax

That Robert LeslieCole Whose Birth is sought to be registered was

born at Halifax Halifax County on September 6, 1921

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

I am the mother of this child and have full knowledge of the facts. My son has always gone under the surname Cole although I was not married at the time of this birth. Attached is a certificate from the records of the Halifax Infants Home where the child was born - this certificte shows the name as Burgwin.

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