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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 DonaldSimmonds Sex Male

Date of Birth July 25, 1922 Place of Birth North PrestonCounty of Halifax

Name of Father Walter Simmonds MAIDEN NAME of Mother Isabella Downey

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

Residence of Father when child was born North Preston 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 Donald Simmonds Address of Applicant Westfall, North Preston Date June 21, 1988

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at North Preston in the County of Halifax

That DonaldSimmonds Whose Birth is sought to be registered was

born at North Preston Halifax County on July 25, 1922

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

Court finding dated April 28, 1988 Stating applicants full name, data of birth, place of birth and parentage.

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