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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000415

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Thomas JosephJohnson Sex Male

Date of Birth August 6, 1921 Place of Birth PrestonCounty of Halifax

Name of Father Willoughby Johnson MAIDEN NAME of Mother Annie Beals

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

Residence of Father when child was born North Preston Present address of Father deceased

Occupation of Father at Birth of child Labourer Place of birth of Father North Preston

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

Signature of Applicant Thomas Joseph Johnson Address of Applicant North Preston Date October 20, 1969

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Thomas JosephJohnson

Born at Preston in the County of Halifax

That Thomas JosephJohnson Whose Birth is sought to be registered was

born at Preston Halifax County on August 6, 1921

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

Census National Register Marriage Record

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