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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600543

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of DonaldCox Sex Male

Date of Birth January 12, 1922 Place of Birth 49 Queen Street, HalifaxCounty of Halifax

Name of Father Peter Blair Cox MAIDEN NAME of Mother Gertrude Cox

Residence of Father when child was born Jeddore, Halifax Co., NS Present address of Father Unknown

Occupation of Father at Birth of child Labourer Place of birth of Father Jean, Labrador

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. A. H. Myers Address of Applicant Head of Jeddore, Halifax Co., NS Date 11 December 1935

Relationship of Applicant to child Aunt

AFFIDAVIT

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

Born at 49 Queen Street, Halifax in the County of Halifax

That DonaldCox Whose Birth is sought to be registered was

born at 49 Queen Street, Halifax Halifax County on January 12, 1922

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

Certificate of Doctor, attached

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