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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000819

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William CliffordColp Sex Male

Date of Birth September 21, 1922 Place of Birth ColptonCounty of Lunenburg

Name of Father Charles Andrew Colp MAIDEN NAME of Mother Gladys Viola Heim

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father Colpton, Lunenburg

Race Name and present address of Physician in attendance at birth

Signature of Applicant Violet Colp Address of Applicant Colpton, Lunenburg Date 14 June 1980

Relationship of Applicant to child None

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William CliffordColp

Born at Colpton in the County of Lunenburg

That William CliffordColp Whose Birth is sought to be registered was

born at Colpton Lunenburg County on September 21, 1922

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

By being present at time of birth

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