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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90500676

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ellas AlvordSlack Sex Male

Date of Birth August 13, 1922 Place of Birth Folly LakeCounty of Colchester

Name of Father Alvord Slack MAIDEN NAME of Mother Ella Maude Cove

Residence of Father when child was born Folly Lake Present address of Father Londonderry Station

Occupation of Father at Birth of child Railway Section Man Place of birth of Father Folly Lake

Race Name and present address of Physician in attendance at birth

Signature of Applicant Alvord Slack Address of Applicant Londonderry Station Date June 18, 1940

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ellas AlvordSlack

Born at Folly Lake in the County of Colchester

That Ellas AlvordSlack Whose Birth is sought to be registered was

born at Folly Lake Colchester County on August 13, 1922

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

That I being his father was present when the child was born.

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