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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000380

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Goldie GlenwoodMartin Sex Male

Date of Birth December 1, 1922 Place of Birth Harmony MillsCounty of Queens

Name of Father Osmond Martin MAIDEN NAME of Mother Annie Marguerite James

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

Residence of Father when child was born Harmony Mills, Queens Present address of Father Tweedside, New Brunswick

Occupation of Father at Birth of child Woodsman Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant goldie G. Martin Address of Applicant Harvey Station, New Brunswick Date 21 July 1969

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Goldie GlenwoodMartin

Born at Harmony Mills in the County of Queens

That Goldie GlenwoodMartin Whose Birth is sought to be registered was

born at Harmony Mills Queens County on December 1, 1922

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

A letter received from Dr. A. C. McLeod, attending physician at the birth of Goldie Glenwood Martin, a copy of which is attached hereto, sets out his record of the birth; also attached is a copy of the record of births maintained in the family bible by Mrs. Goldie Marguerite Martin, who lives at Tweedside, County of York, New Brunswick.

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