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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000006

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harold MarcellYork Sex Male

Date of Birth December 28, 1922 Place of Birth DartmouthCounty of Halifax

Name of Father Henry William York MAIDEN NAME of Mother Catherine Edwards

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

Residence of Father when child was born Dartmouth, Halifax Present address of Father

Occupation of Father at Birth of child Fireman Place of birth of Father Dartmouth, Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. H. York Address of Applicant 28 Brookside Avenue, Dartmouth, Halifax Date 24 January 1947

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harold MarcellYork

Born at Dartmouth in the County of Halifax

That Harold MarcellYork Whose Birth is sought to be registered was

born at Dartmouth Halifax County on December 28, 1922

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

I am the mother of Harold Marcell York

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