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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90700039

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Andrew CliffordThomas Sex Male

Date of Birth June 17, 1922 Place of Birth Indian PointCounty of Lunenburg

Name of Father Clifford Percy Thomas MAIDEN NAME of Mother Vernie May Wentzell

Residence of Father when child was born Indian Point, Lunenburg Co., NS Present address of Father Indian Point, Lunenburg Co., NS

Occupation of Father at Birth of child Merchant Place of birth of Father Tancook, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Vernie May thomas Address of Applicant Indian Point, Lunenburg Co., NS Date 25 January 1939

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Andrew CliffordThomas

Born at Indian Point in the County of Lunenburg

That Andrew CliffordThomas Whose Birth is sought to be registered was

born at Indian Point Lunenburg County on June 17, 1922

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

I am the mother of the said Andrew Clifford Thomas

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