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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700277

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Aubrey PrestonSimms Sex Male

Date of Birth October 9, 1922 Place of Birth BridgetownCounty of Annapolis

Name of Father Arthur Primrose Simms MAIDEN NAME of Mother Lillian Gibson

Residence of Father when child was born Bridgetown, Annapolis Co., NS Present address of Father Pleasantville, New Jersey, USA

Occupation of Father at Birth of child Farmer Place of birth of Father Bridgetown, Annapolis Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lillian Simons Address of Applicant 110 McKinley Avenue, Bridgetown, Annapolis Co., NS Date 14 August 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Aubrey PrestonSimms

Born at Bridgetown in the County of Annapolis

That Aubrey PrestonSimms Whose Birth is sought to be registered was

born at Bridgetown Annapolis County on October 9, 1922

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

There is no special circumstances to base the fact of my sons birth other than my own memory of event.

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