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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000230

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clarence GeorgeConrad Sex Male

Date of Birth November 18, 1922 Place of Birth HalifaxCounty of Halifax

Name of Father Milledge Atwood Conrad MAIDEN NAME of Mother Violet Verlie Peters

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

Residence of Father when child was born Halifax Present address of Father Halifax

Occupation of Father at Birth of child Teamster Place of birth of Father Liverpool, Queens

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mildred Verlie Jenkins Address of Applicant 9 St. Paul Street Date 10 January 1958

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clarence GeorgeConrad

Born at Halifax in the County of Halifax

That Clarence GeorgeConrad Whose Birth is sought to be registered was

born at Halifax Halifax County on November 18, 1922

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

I am his sister. (family bible, school and insurance records)

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