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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100054

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of ThomasPaddock Sex Male

Date of Birth May 21, 1922 Place of Birth YarmouthCounty of Yarmouth

Name of Father Edward Paddock MAIDEN NAME of Mother Mary Ellen Bangay

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

Residence of Father when child was born Yarmouth Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Thomas Paddock Address of Applicant 10 Pearl Street, Yarmouth Date 13 August 1986

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of ThomasPaddock

Born at Yarmouth in the County of Yarmouth

That ThomasPaddock Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on May 21, 1922

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

I have always celebrated my birthday on the 21st day of May each year in such fashion that my actual date of birth was in the year 1922

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