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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000150

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William ReynoldsSmith Sex Male

Date of Birth January 18, 1922 Place of Birth MorganvilleCounty of Digby

Name of Father Horace Murray Smith MAIDEN NAME of Mother Ethel Viola DeForest

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

Residence of Father when child was born Morganville, Digby Present address of Father Morganville, Digby

Occupation of Father at Birth of child Farmer Place of birth of Father Morganville, Digby

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ethel Viola Smith Address of Applicant Box 213, Bear River, Annapolis Date 6 September 1952

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William ReynoldsSmith

Born at Morganville in the County of Digby

That William ReynoldsSmith Whose Birth is sought to be registered was

born at Morganville Digby County on January 18, 1922

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

I as mother have always been aware of the fact (certificate from school records, insurance policy, family record book and also supporting declarations)

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