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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000519

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lawrence SidneyWilliams Sex Male

Date of Birth July 15, 1922 Place of Birth Barneys River StationCounty of Pictou

Name of Father Fred Williams MAIDEN NAME of Mother Georgie Grant

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

Residence of Father when child was born Barneys River Station, Pictou Present address of Father Deceased

Occupation of Father at Birth of child Lumberman Place of birth of Father Marshy Hope, Pictou

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lawrence S. Williams Address of Applicant Barneys River Station, Pictou Date 3 September 1974

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lawrence SidneyWilliams

Born at Barneys River Station in the County of Pictou

That Lawrence SidneyWilliams Whose Birth is sought to be registered was

born at Barneys River Station Pictou County on July 15, 1922

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

Baptismal Certificate

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