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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000630

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Medford WentworthColdwell Sex Male

Date of Birth May 13, 1921 Place of Birth WolfvilleCounty of Kings

Name of Father Arthur Coldwell MAIDEN NAME of Mother Augusta Mae Bishop

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father Wolfville

Race Name and present address of Physician in attendance at birth

Signature of Applicant Medford W. Coldwell Address of Applicant Wolfville Date April 27, 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Medford WentworthColdwell

Born at Wolfville in the County of Kings

That Medford WentworthColdwell Whose Birth is sought to be registered was

born at Wolfville Kings County on May 13, 1921

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

Having been next door neighbour of Arthur Coldwell for years I know and remember well his birth (Medford's birth) being May 13, 1921 I swear this to be the truth

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