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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000001

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clark GarfieldOickle Sex Male

Date of Birth February 6, 1922 Place of Birth MaplewoodCounty of Lunenburg

Name of Father Garfield Oickle MAIDEN NAME of Mother Hazel Beatrice Wentzell

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

Residence of Father when child was born Branch LaHave, Lunenburg Present address of Father

Occupation of Father at Birth of child Farmer Place of birth of Father Lower Branch, Lunenburg

Race Name and present address of Physician in attendance at birth

Signature of Applicant Hazel Beatrice Oickle Address of Applicant Branch LaHave, Lunenburg Date 6 February 1922

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clark GarfieldOickle

Born at Maplewood in the County of Lunenburg

That Clark GarfieldOickle Whose Birth is sought to be registered was

born at Maplewood Lunenburg County on February 6, 1922

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

I am his mother

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