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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92000778

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth January 23, 1921 Place of Birth YarmouthCounty of Yarmouth

Name of Father George Victor Helms MAIDEN NAME of Mother Carolyn Weekes

Residence of Father when child was born Yarmouth, NS Present address of Father Glendale, California, USA

Occupation of Father at Birth of child Transportation Manager Place of birth of Father Yarmouth, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant G. W. T. Farish Address of Applicant Yarmouth, NS Date 7 October 1941

Relationship of Applicant to child Doctor

AFFIDAVIT

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

Born at Yarmouth in the County of Yarmouth

That George WeekesHelms Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on January 23, 1921

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

I was the doctor that attended at the birth of George Weekes Helms and know the above affidavit to be true.

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