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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100039

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lowell ArthurWagner Sex Male

Date of Birth April 20, 1921 Place of Birth New CanadaCounty of Lunenburg

Name of Father Alton Wagner MAIDEN NAME of Mother Elva Sarty

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

Residence of Father when child was born New Canada Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father New Canada

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lowell Wagner Address of Applicant Shubenacadie Date February 8, 1984

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lowell ArthurWagner

Born at New Canada in the County of Lunenburg

That Lowell ArthurWagner Whose Birth is sought to be registered was

born at New Canada Lunenburg County on April 20, 1921

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

Census report National registration extract from school records

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