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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000188

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Howard HardyDavison Sex Male

Date of Birth January 19, 1923 Place of Birth Black RiverCounty of Kings

Name of Father Lee Roy Davison MAIDEN NAME of Mother Jessie Fraser Brown

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

Residence of Father when child was born Black River Kings Co. Ns Present address of Father Gaspereau, Kings Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Black River, Kings Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jessie Fraser Davison Address of Applicant Gaspereau, Kings Co., NS Date 20 April 1955

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Howard HardyDavison

Born at Black River in the County of Kings

That Howard HardyDavison Whose Birth is sought to be registered was

born at Black River Kings County on January 19, 1923

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

I visited at the home at the time (signed Kathleen Brown) (School record - family bible record)

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