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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000442

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harold WilliamCampbell Sex Male

Date of Birth December 13, 1921 Place of Birth StellartonCounty of Pictou

Name of Father John William Campbell MAIDEN NAME of Mother  MacKeen

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

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

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

Race Caucasian Name and present address of Physician in attendance at birth Dr. H.B. Whitman

Signature of Applicant Robert A. Stroud Address of Applicant 502 Maritime Bldg, New Glasgow Date October 23, 1970

Relationship of Applicant to child None

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harold WilliamCampbell

Born at Stellarton in the County of Pictou

That Harold WilliamCampbell Whose Birth is sought to be registered was

born at Stellarton Pictou County on December 13, 1921

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

From school record and information received from the Dominion Bureau of Statistics

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