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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000736

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John FrancisKelly Sex Male

Date of Birth May 9, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father John Francis Kelly MAIDEN NAME of Mother Elizabeth Jane Reynolds

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

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

Occupation of Father at Birth of child RCMP Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant John F. Kelly Address of Applicant 6447 Cloverdale Rd. Halifax Date March 3, 1978

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John FrancisKelly

Born at Halifax in the County of Halifax

That John FrancisKelly Whose Birth is sought to be registered was

born at Halifax Halifax County on May 9, 1921

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

Baptismal

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