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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000047

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Douglas MalcolmJayne Sex Male

Date of Birth February 21, 1923 Place of Birth YarmouthCounty of Yarmouth

Name of Father James Willis Jayne MAIDEN NAME of Mother Estella MacGarron

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

Residence of Father when child was born Kirk Street Yarmouth Ns Present address of Father Kirk Street, Yarmouth, NS

Occupation of Father at Birth of child Telephone Lineman & Repairman Place of birth of Father Pleasantville, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Estella M. Jayne Address of Applicant 43 John Street, Yarmouth, NS Date 2 May 1947

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Douglas MalcolmJayne

Born at Yarmouth in the County of Yarmouth

That Douglas MalcolmJayne Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on February 21, 1923

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

I, Estella Mae Jayne am the mother of Douglas Malcolm Jayne

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