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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600753

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ross ClevelandMerriam Sex Male

Date of Birth August 5, 1921 Place of Birth Spencers IslandCounty of Cumberland

Name of Father Leslie Trufant Merriam MAIDEN NAME of Mother Inez Lena Borden

Residence of Father when child was born Spencers Island, Cumberland Co., NS Present address of Father Spencers Island, Cumberland Co., NS

Occupation of Father at Birth of child Master Mariner Place of birth of Father Port Greville, Cumberland Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Inez Borden Merriam Address of Applicant Spencers Island, Cumberland Co., NS Date 29 August 1938

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ross ClevelandMerriam

Born at Spencers Island in the County of Cumberland

That Ross ClevelandMerriam Whose Birth is sought to be registered was

born at Spencers Island Cumberland County on August 5, 1921

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

As I am the mother of Ross Cleveland Merriam. The birth is recorded in the family bible.

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