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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700327

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jack LangfordTremaine Sex Male

Date of Birth March 8, 1922 Place of Birth RockinghamCounty of Halifax

Name of Father Charles F. Tremaine MAIDEN NAME of Mother Mary G. Strachan

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

Occupation of Father at Birth of child Barrister Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Charles F. Tremaine Address of Applicant Rockingham, Halifax Co., NS Date 28 May 1942

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jack LangfordTremaine

Born at Rockingham in the County of Halifax

That Jack LangfordTremaine Whose Birth is sought to be registered was

born at Rockingham Halifax County on March 8, 1922

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

I am the father of said Jack Langford Tremaine and was present in the home on the day the birth occurred.

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