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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100117

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lauchie HamptonSmith Sex Male

Date of Birth August 12, 1922 Place of Birth Campbell MountainCounty of Inverness

Name of Father Ernest Bayne Smith MAIDEN NAME of Mother Harriett Hampton

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

Residence of Father when child was born Campbell Mountain Present address of Father Campbell Mountain

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant C.E. Waye Address of Applicant 7 Steed Crt. Dartmouth Date 19 January 1970

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lauchie HamptonSmith

Born at Campbell Mountain in the County of Inverness

That Lauchie HamptonSmith Whose Birth is sought to be registered was

born at Campbell Mountain Inverness County on August 12, 1922

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

1940 National Registration of Canada and marriage extract

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