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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000276

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Adelbert WilsonTower Sex Male

Date of Birth April 11, 1921 Place of Birth GlenholmeCounty of Colchester

Name of Father William Edward Tower MAIDEN NAME of Mother Ada Irene Blair

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

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

Occupation of Father at Birth of child Labourer Place of birth of Father Dorchester Cape, New Brunswick

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

Signature of Applicant Ada Irene Blair Tower Address of Applicant Humphreys Station, New Brunswick Date May 25, 1959

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Adelbert WilsonTower

Born at Glenholme in the County of Colchester

That Adelbert WilsonTower Whose Birth is sought to be registered was

born at Glenholme Colchester County on April 11, 1921

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

That I am the natural Mother of the said Adelbert Wilson Tower, who was born to me on the 11th day of April, A.D. 1921; that I brought up, maintained and cared for the said Adelbert Wilson Tower as my son; that the said Adelbert Wilson Tower is the fourth child born to me;

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