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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800166

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth September 25, 1922 Place of Birth HalifaxCounty of Halifax

Name of Father Albert F. Emery MAIDEN NAME of Mother Agnes May Brown

Residence of Father when child was born Saint John, New Brunswick Present address of Father Deceased

Occupation of Father at Birth of child Traveller Place of birth of Father Saint John, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. A. M. Emery Address of Applicant 158 Beech Street, Halifax, NS Date 14 January 1944

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Halifax in the County of Halifax

That John EricEmery Whose Birth is sought to be registered was

born at Halifax Halifax County on September 25, 1922

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

I am the mother of John Eric Emery and know positively that John Eric Emery was born at Halifax, Nova Scotia, September 25th, 1922.

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