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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000084

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Timothy EricDeYoung Sex Male

Date of Birth December 22, 1922 Place of Birth DarmouthCounty of Halifax

Name of Father Ralph DeYoung MAIDEN NAME of Mother Annie Graham

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

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant T. E. DeYoung Address of Applicant Dartmouth, Halifax Date 28 March 1949

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Timothy EricDeYoung

Born at Darmouth in the County of Halifax

That Timothy EricDeYoung Whose Birth is sought to be registered was

born at Darmouth Halifax County on December 22, 1922

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

Certificate of baptism attached

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