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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000155

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Glen JestonWagner Sex Male

Date of Birth November 9, 1923 Place of Birth New CanadaCounty of Lunenburg

Name of Father Alton Henley Wagner MAIDEN NAME of Mother Elva Mae Sarty

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

Residence of Father when child was born New Canada Lunenburg Co. Ns Present address of Father Newport, Hants Co., NS

Occupation of Father at Birth of child Lumberman Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Glen Jeston Wagner Address of Applicant Arcadia, Yarmouth Co., NS Date 24 January 1953

Relationship of Applicant to child Applicant making application

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Glen JestonWagner

Born at New Canada in the County of Lunenburg

That Glen JestonWagner Whose Birth is sought to be registered was

born at New Canada Lunenburg County on November 9, 1923

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

Cradle roll certificate

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