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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000267

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frederick SmallwoodJohnson Sex Male

Date of Birth August 27, 1922 Place of Birth BridgetownCounty of Annapolis

Name of Father James Herbert Johnson MAIDEN NAME of Mother Elizabeth Stevens

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

Residence of Father when child was born Bridgetown, Annapolis Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Weymouth, Digby

Race Name and present address of Physician in attendance at birth

Signature of Applicant Elizabeth Johnson Address of Applicant Middleton, Annapolis Date 5 June 1961

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frederick SmallwoodJohnson

Born at Bridgetown in the County of Annapolis

That Frederick SmallwoodJohnson Whose Birth is sought to be registered was

born at Bridgetown Annapolis County on August 27, 1922

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

Family bible (see Notorial Affidavit of Kenneth L. Crowell attached) Search of School Records (see Notarial Affidavit of Kenneth L. Crowell attached)

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