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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000228

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James StuartSelig Sex Male

Date of Birth January 25, 1921 Place of Birth North BrookfieldCounty of Queens

Name of Father Noble Selig MAIDEN NAME of Mother Hazel Wile

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

Residence of Father when child was born North Brookfield Present address of Father Bridgewater

Occupation of Father at Birth of child Labourer Place of birth of Father Bakers Settlement

Race Caucasian Name and present address of Physician in attendance at birth Dr. A.C. MacLeod

Signature of Applicant Hazel Selig Address of Applicant Bridgewater Date October 19, 1956

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James StuartSelig

Born at North Brookfield in the County of Queens

That James StuartSelig Whose Birth is sought to be registered was

born at North Brookfield Queens County on January 25, 1921

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

Mother of James Stuart Selig Baptism Certificate

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