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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000167

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Sherman JeremiahNickerson Sex Male

Date of Birth July 23, 1922 Place of Birth SambroCounty of Halifax

Name of Father William George Nickerson MAIDEN NAME of Mother Nema Loretta 

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

Residence of Father when child was born Pennant, Halifax Present address of Father 196 Beech Street

Occupation of Father at Birth of child Fisherman Place of birth of Father Pennant, Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Sherman J. Nickerson Address of Applicant 39 Howard Street, Halifax Date 14 July 1953

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Sherman JeremiahNickerson

Born at Sambro in the County of Halifax

That Sherman JeremiahNickerson Whose Birth is sought to be registered was

born at Sambro Halifax County on July 23, 1922

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

Information supplied by parents and certificate of baptism attached here to

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