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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90500405

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of George David LorrinGrady Sex Male

Date of Birth August 4, 1922 Place of Birth Clarks HarbourCounty of Shelburne

Name of Father John Francis Grady MAIDEN NAME of Mother Lela Serepta Atwood

Residence of Father when child was born Clarks Harbour Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lela Serepta MacKinnon Address of Applicant Clarks Harbour Date March 15, 1940

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of George David LorrinGrady

Born at Clarks Harbour in the County of Shelburne

That George David LorrinGrady Whose Birth is sought to be registered was

born at Clarks Harbour Shelburne County on August 4, 1922

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

Mother of Applicant

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