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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000143

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 18, 1923 Place of Birth AmherstCounty of Cumberland

Name of Father William Alphonso Shea MAIDEN NAME of Mother Lillian Maude Brown

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

Residence of Father when child was born Amherst Cumberland Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Painter Place of birth of Father Manassette Lake, Guysborough Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Douglas Vaughn Shea Address of Applicant Springhill, Cumberland Co., NS Date 19 April 1952

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Amherst in the County of Cumberland

That Douglas VaughnShea Whose Birth is sought to be registered was

born at Amherst Cumberland County on April 18, 1923

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

I am the mother of Douglas Vaughn Shea

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