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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700980

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John DouglasSelig Sex Male

Date of Birth August 18, 1922 Place of Birth LawrencetownCounty of Annapolis

Name of Father Harry Anderson Selig MAIDEN NAME of Mother Cora Violet woodworth

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

Occupation of Father at Birth of child Farm Labourer Place of birth of Father East Clifford, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Cora Violet Selig Address of Applicant Bridgetown, Annapolis Co., NS Date 7 September 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John DouglasSelig

Born at Lawrencetown in the County of Annapolis

That John DouglasSelig Whose Birth is sought to be registered was

born at Lawrencetown Annapolis County on August 18, 1922

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

That I am the mother of the said John Douglas Selig and recall all the circumstances in connection with same.

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