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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000097

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of donald MerleJollymore Sex Male

Date of Birth July 28, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father John Frederick Jollymore MAIDEN NAME of Mother Dorothy May OHearn

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

Residence of Father when child was born Creighton Street Halifax Ns Present address of Father 23 Sebastian Place, Halifax, NS

Occupation of Father at Birth of child Foreman at National Fish Company Place of birth of Father Terence Bay, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant J. F. Jollymore Address of Applicant 23 Sebastian Place, Halifax, NS Date 29 August 1949

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of donald MerleJollymore

Born at Halifax in the County of Halifax

That donald MerleJollymore Whose Birth is sought to be registered was

born at Halifax Halifax County on July 28, 1923

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

I am the father. Certificate of Dr. Grace Rice attached.

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