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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100092

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Charles IrvingManthorne Sex Male

Date of Birth May 1, 1921 Place of Birth LiverpoolCounty of Queens

Name of Father Aubrey Ernest Manthorne MAIDEN NAME of Mother Elizabeth Myrtle Frelick

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

Residence of Father when child was born Beach Meadows Present address of Father deceased

Occupation of Father at Birth of child Cook Place of birth of Father Port Medway

Race Name and present address of Physician in attendance at birth

Signature of Applicant Shirley Slaunwhite Address of Applicant 95 Prince St. Lower Sackville Date March 19, 1985

Relationship of Applicant to child Daughter

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Charles IrvingManthorne

Born at Liverpool in the County of Queens

That Charles IrvingManthorne Whose Birth is sought to be registered was

born at Liverpool Queens County on May 1, 1921

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

Baptismal Marriage Extract

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