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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000957

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gerald KennethDavis Sex Male

Date of Birth November 12, 1922 Place of Birth HalifaxCounty of Halifax

Name of Father Henry Joseph Davis MAIDEN NAME of Mother Mabel Norris

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

Residence of Father when child was born Cobequid Road, Lower Sackville, Halifax Present address of Father Lower Sackville, Halifax

Occupation of Father at Birth of child Carpenter Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Roy T. Davis Address of Applicant 73 Hillside Avenue, Lower Sackville, Halifax Date 22 November 1983

Relationship of Applicant to child Sister in Law

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gerald KennethDavis

Born at Halifax in the County of Halifax

That Gerald KennethDavis Whose Birth is sought to be registered was

born at Halifax Halifax County on November 12, 1922

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

Baptismal and marriage extract

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