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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000188

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Robert DanielPate Sex Male

Date of Birth April 15, 1922 Place of Birth L'ArdoiseCounty of Richmond

Name of Father Henry Pate MAIDEN NAME of Mother Sadie Martell

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

Residence of Father when child was born L'Ardoise, Richmond Present address of Father L'Ardoise West, Richmond

Occupation of Father at Birth of child Fireman, SS Lady Laurier Place of birth of Father L'Ardoise West, Richmond

Race Name and present address of Physician in attendance at birth

Signature of Applicant R. D. Pate Address of Applicant 34 St. Quinlen Street, Calgary, Alberta Date January 1955

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Robert DanielPate

Born at L'Ardoise in the County of Richmond

That Robert DanielPate Whose Birth is sought to be registered was

born at L'Ardoise Richmond County on April 15, 1922

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

I am the father and although not at home when the child was born, I solemnly declare that I know he was born on April 19th, 1922, (baptism record)

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