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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100037

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Eldon Harry Moore Sex Male

Date of Birth March 8, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Gladys Mae Moore

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Gladys King Address of Applicant 1082 Prospect Road, New Minas Date September 20, 1983

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Eldon Harry Moore

Born at Halifax in the County of Halifax

That Eldon Harry Moore Whose Birth is sought to be registered was

born at Halifax Halifax County on March 8, 1921

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

That I was the Mother of the said Eldon Harry Moore

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