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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91400319

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lelland ElRoyCox Sex Male

Date of Birth January 18, 1923 Place of Birth BrooklynCounty of Annapolis

Name of Father George LeRoy Cox MAIDEN NAME of Mother Veria Muriel Carson

Residence of Father when child was born Brooklyn, Annapolis Co., NS Present address of Father Brooklyn, Annapolis Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Medford, Kings Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Veria Muriel Cox Address of Applicant Brooklyn, Annapolis Co., NS Date 11 February 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lelland ElRoyCox

Born at Brooklyn in the County of Annapolis

That Lelland ElRoyCox Whose Birth is sought to be registered was

born at Brooklyn Annapolis County on January 18, 1923

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

Mother of Lelland ElRoy Cox. Mistake of F. S. Messinger not having posted the postal for papers to come to mother from Halifax.

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