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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000145

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Allan BrooksCann Sex Male

Date of Birth July 19, 1922 Place of Birth YarmouthCounty of Yarmouth

Name of Father James Arthur Cann MAIDEN NAME of Mother Marion Helen Gould

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

Residence of Father when child was born Yarmouth Present address of Father Deceased

Occupation of Father at Birth of child Bookkeeper Place of birth of Father Yarmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant A. B. Cann Address of Applicant 467 111th Street, Shawinigan South, Quebec Date 8 October 1952

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Allan BrooksCann

Born at Yarmouth in the County of Yarmouth

That Allan BrooksCann Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on July 19, 1922

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

I was attending physician at birth of applicant and have said date on my records. - signed Charles K. Fuller M.D.

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