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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91600174

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Weldon NormanMacLeod Sex Male

Date of Birth September 21, 1921 Place of Birth ImperoyalCounty of Halifax

Name of Father Norman MacLeod MAIDEN NAME of Mother Helen Nelson

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

Occupation of Father at Birth of child Boiler Maker Place of birth of Father Prince Edward Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Helen MacLeod Address of Applicant Imperoyal, Halifax Co., NS Date 20 September 1941

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Weldon NormanMacLeod

Born at Imperoyal in the County of Halifax

That Weldon NormanMacLeod Whose Birth is sought to be registered was

born at Imperoyal Halifax County on September 21, 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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