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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100048

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James ArthurDavies Sex Male

Date of Birth April 13, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father John Davies MAIDEN NAME of Mother Florence Rafter

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 plumber Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant James A. Davies Address of Applicant 54 Hillside, Lower Sackville Date May 7, 1984

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James ArthurDavies

Born at Halifax in the County of Halifax

That James ArthurDavies Whose Birth is sought to be registered was

born at Halifax Halifax County on April 13, 1921

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

Baptismal

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