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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600774

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kenneth LeeMansfield Sex Male

Date of Birth May 24, 1921 Place of Birth WestfieldCounty of Queens

Name of Father Judson Henry Mansfield MAIDEN NAME of Mother Iris Idella Frail

Residence of Father when child was born Westfield, Queens Co., NS Present address of Father Westfield, Queens Co., NS

Occupation of Father at Birth of child Labourer Place of birth of Father Westfield, Queens Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Judson Mansfield Address of Applicant Westfield, Queens Co., NS Date 15 June 1937

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kenneth LeeMansfield

Born at Westfield in the County of Queens

That Kenneth LeeMansfield Whose Birth is sought to be registered was

born at Westfield Queens County on May 24, 1921

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

I am his mother

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