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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100158

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Leo DouglasHadley Sex Male

Date of Birth September 10, 1921 Place of Birth GuysboroughCounty of Guysborough

Name of Father Arthur Bernard Hadley MAIDEN NAME of Mother Mary Gertrude Jones

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

Residence of Father when child was born Guysborough Present address of Father Guysborough

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Gertrude Jones Address of Applicant Guysborough Date 6 October 1921

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Leo DouglasHadley

Born at Guysborough in the County of Guysborough

That Leo DouglasHadley Whose Birth is sought to be registered was

born at Guysborough Guysborough County on September 10, 1921

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

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