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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000031

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frederick JosephHartley Sex Male

Date of Birth May 28, 1922 Place of Birth South East PassageCounty of Halifax

Name of Father Richard Hartley MAIDEN NAME of Mother Catherine Osborne

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

Residence of Father when child was born South East Passage, Halifax Present address of Father 73 Prince Albert Road, Dartmouth

Occupation of Father at Birth of child Labourer Place of birth of Father South East Passage, Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Catherine Hartley Address of Applicant Dartmouth Date 3 July 1947

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frederick JosephHartley

Born at South East Passage in the County of Halifax

That Frederick JosephHartley Whose Birth is sought to be registered was

born at South East Passage Halifax County on May 28, 1922

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

I am the mother

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