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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100009

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Franklin LeeBlauvelt Sex Male

Date of Birth January 8, 1922 Place of Birth GaveltonCounty of Yarmouth

Name of Father Charles Haskel Blauvelt MAIDEN NAME of Mother Isaline Annabelle Wood

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

Residence of Father when child was born Gavelton, Yarmouth Present address of Father

Occupation of Father at Birth of child Place of birth of Father Tusket, Yarmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant D. N. Comeau Address of Applicant Eel Brook, Yarmouth Date 22 April 1922

Relationship of Applicant to child Parish Priest

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Franklin LeeBlauvelt

Born at Gavelton in the County of Yarmouth

That Franklin LeeBlauvelt Whose Birth is sought to be registered was

born at Gavelton Yarmouth County on January 8, 1922

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

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