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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

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TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Cyril WilliamWells Sex Male

Date of Birth October 31, 1922 Place of Birth Eastern PassageCounty of Halifax

Name of Father gibson Wells MAIDEN NAME of Mother Willietta Horne

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

Residence of Father when child was born Eastern Passage, Halifax Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Eastern Passage, Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edna Wells Address of Applicant Eastern Passage, Halifax Date 8 September 1987

Relationship of Applicant to child Wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Cyril WilliamWells

Born at Eastern Passage in the County of Halifax

That Cyril WilliamWells Whose Birth is sought to be registered was

born at Eastern Passage Halifax County on October 31, 1922

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

Baptismal certificate Marriage number 18-02-006748 Marriage number 50-02-002923

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