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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000287

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ucal HavelockMarsman Sex Male

Date of Birth April 6, 1922 Place of Birth Hammonds PlainsCounty of Halifax

Name of Father Thomas Fletcher Marsman MAIDEN NAME of Mother Neta Ackerson

Residence of Father when child was born y Present address of Father Hammonds Plains, Halifax

Occupation of Father at Birth of child Croper Place of birth of Father Hammonds Plains, Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Thomas F. Marsman Address of Applicant Hammonds Plains, Halifax Date 12 September 1962

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ucal HavelockMarsman

Born at Hammonds Plains in the County of Halifax

That Ucal HavelockMarsman Whose Birth is sought to be registered was

born at Hammonds Plains Halifax County on April 6, 1922

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

I am his father. Family Record. School record.

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