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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000739

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harold ArchibaldKizer Sex Male

Date of Birth August 19, 1922 Place of Birth BridgewaterCounty of Lunenburg

Name of Father Calvin theophilus Kizer MAIDEN NAME of Mother Laura Irene Oickle

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

Residence of Father when child was born Rose Bay, Lunenburg Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Rose Bay, Lunenburg

Race Name and present address of Physician in attendance at birth

Signature of Applicant Harold Archibald Kizer Address of Applicant RR #2, First South, Lunenburg Date 20 February 1979

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harold ArchibaldKizer

Born at Bridgewater in the County of Lunenburg

That Harold ArchibaldKizer Whose Birth is sought to be registered was

born at Bridgewater Lunenburg County on August 19, 1922

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

21 January in the year of our Lord, 1924, male - Harold Archibald Kizer born 19th August 1922 of Calvin and Laura Kizer, residence of Lower Rose Bay, was baptized according to the right of the United Church of Canada, by the Rev. P. M. Hartley. This is a true and faithful record of birth and baptism as kept by the United Church of Canada, in its Archives at the Atlantic School of Theology, Halifax.

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