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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000820

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Spicer CarmichaelHazel Sex Male

Date of Birth February 4, 1922 Place of Birth Baxters HarbourCounty of Kings

Name of Father James Joshua Hazel MAIDEN NAME of Mother Ethel Rand

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Baxters Harbour, Kings Present address of Father Deceased

Occupation of Father at Birth of child Mail Driver Place of birth of Father Arlington, Kings

Race Name and present address of Physician in attendance at birth

Signature of Applicant Spicer Carmichael Address of Applicant RR #3, Parrsboro, Cumberland Date 6 March 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Spicer CarmichaelHazel

Born at Baxters Harbour in the County of Kings

That Spicer CarmichaelHazel Whose Birth is sought to be registered was

born at Baxters Harbour Kings County on February 4, 1922

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

Was entered in the family Holy Bible, a copy hereto attached

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