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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700508

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of George HaroldCrowell Sex Male

Date of Birth November 5, 1922 Place of Birth Barrington PassageCounty of Shelburne

Name of Father Harold Edgar Crowell MAIDEN NAME of Mother Maude Hazel Thomas

Residence of Father when child was born Barrington Passage, Shelburne Co., NS Present address of Father Barrington Passage, Shelburne Co., NS

Occupation of Father at Birth of child Fish Buyer Place of birth of Father Barrington Passage, Shelburne Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Maude H. Crowell Address of Applicant Barrington Passage, Shelburne Co., NS Date 31 March 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of George HaroldCrowell

Born at Barrington Passage in the County of Shelburne

That George HaroldCrowell Whose Birth is sought to be registered was

born at Barrington Passage Shelburne County on November 5, 1922

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

I being his mother of course know this to be correct

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