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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000183

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Herbert WarrenHolmes Sex Male

Date of Birth August 14, 1922 Place of Birth MacPherson MillsCounty of Pictou

Name of Father Andrew Holmes MAIDEN NAME of Mother Charlene MacIntosh

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

Residence of Father when child was born MacPherson Mills, Pictou Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father MacPherson Mills, Pictou

Race Name and present address of Physician in attendance at birth

Signature of Applicant Herbert Warren Holmes Address of Applicant RR #1, MacPherson Mills, Pictou Date August 1954

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Herbert WarrenHolmes

Born at MacPherson Mills in the County of Pictou

That Herbert WarrenHolmes Whose Birth is sought to be registered was

born at MacPherson Mills Pictou County on August 14, 1922

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

I was present at the birth (baptism certificate and family record)

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