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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000140

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Theodore RaymondWard Sex Male

Date of Birth August 10, 1921 Place of Birth Melvern SquareCounty of Annapolis

Name of Father Burpee Ernest Ward MAIDEN NAME of Mother Hattie Allen

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

Residence of Father when child was born Melvern Square Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Lake Paul

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

Signature of Applicant Theodore Raymond Ward Address of Applicant Kentville Date December 29, 1950

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Theodore RaymondWard

Born at Melvern Square in the County of Annapolis

That Theodore RaymondWard Whose Birth is sought to be registered was

born at Melvern Square Annapolis County on August 10, 1921

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

That I was present as the home where and when Theodore Raymond Ward was born on August 10, 1921. I am 15 years senior to the applicant. I have a clear recollection of the event. (Declaration and letter re. school record attached)

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