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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000782

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Stanley WilbertPick Sex Male

Date of Birth March 17, 1922 Place of Birth White RockCounty of Kings

Name of Father Partlo Pick MAIDEN NAME of Mother Edna 

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

Residence of Father when child was born White Rock, Kings Present address of Father

Occupation of Father at Birth of child Millman Place of birth of Father White Rock, Kings

Race Name and present address of Physician in attendance at birth

Signature of Applicant Beatrice Pick Address of Applicant 190 Rocky Lake Drive, Bedford, Halifax Date 6 November 1979

Relationship of Applicant to child Wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Stanley WilbertPick

Born at White Rock in the County of Kings

That Stanley WilbertPick Whose Birth is sought to be registered was

born at White Rock Kings County on March 17, 1922

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

1. School record 2. Census

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