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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100083

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Laurie MacRaeMaxwell Sex Male

Date of Birth September 3, 1922 Place of Birth HalifaxCounty of Halifax

Name of Father Charles A. Maxwell MAIDEN NAME of Mother Muriel 

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

Residence of Father when child was born Salt Springs, Pictou Present address of Father

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Laurie Maxwell Address of Applicant Date March 1987

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Laurie MacRaeMaxwell

Born at Halifax in the County of Halifax

That Laurie MacRaeMaxwell Whose Birth is sought to be registered was

born at Halifax Halifax County on September 3, 1922

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

Records of adoption, petition and consent and records of Halifax Infants Home, filed under adoption number 87-02-0001126. Extract from marriage.

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