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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91900719

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Francis ColemanKaiser Sex Male

Date of Birth September 7, 1923 Place of Birth Port BickertonCounty of Guysborough

Name of Father Jacob Kaiser MAIDEN NAME of Mother Jane Avery

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Port Bickerton, Guysborough Co., NS Present address of Father Port Bickerton, Guysborough Co., NS

Occupation of Father at Birth of child Fisherman Place of birth of Father Port Bickerton, Guysborough Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jane Kaiser Address of Applicant Port Bickerton, Guysborough Co., NS Date 22 September 1945

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Francis ColemanKaiser

Born at Port Bickerton in the County of Guysborough

That Francis ColemanKaiser Whose Birth is sought to be registered was

born at Port Bickerton Guysborough County on September 7, 1923

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

I am his mother

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