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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000991

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John LawrenceNaugler Sex Male

Date of Birth August 7, 1922 Place of Birth CamperdownCounty of Lunenburg

Name of Father Fred Solomon Naugler MAIDEN NAME of Mother Jennie Belle Stewart

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father Conquerall Mills, Lunenburg

Race Name and present address of Physician in attendance at birth

Signature of Applicant John Lawrence Naugler Address of Applicant RR #1, Italy Cross, Lunenburg Date 25 July 1984

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John LawrenceNaugler

Born at Camperdown in the County of Lunenburg

That John LawrenceNaugler Whose Birth is sought to be registered was

born at Camperdown Lunenburg County on August 7, 1922

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

Certificate of baptism (enclosed) Affidavit from mother, Jennie Belle Naugler

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