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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100043

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ronald StanleyHiltz Sex Male

Date of Birth March 21, 1922 Place of Birth Martins RiverCounty of Lunenburg

Name of Father Nathan Alexander Hiltz MAIDEN NAME of Mother Alice Louise Spidel

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

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Martins River, Lunenburg

Race Name and present address of Physician in attendance at birth

Signature of Applicant ronald Stanley Hiltz Address of Applicant Box 64, Mahone Bay, Lunenburg Date 23 March 1986

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ronald StanleyHiltz

Born at Martins River in the County of Lunenburg

That Ronald StanleyHiltz Whose Birth is sought to be registered was

born at Martins River Lunenburg County on March 21, 1922

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

Enclosed Baptism certificate and marriage certificate of parents

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