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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000203

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Albert GarfieldBurgess Sex Male

Date of Birth January 1, 1923 Place of Birth Windsor Street, HalifaxCounty of Halifax

Name of Father William Burgess MAIDEN NAME of Mother Mable Burgess

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

Residence of Father when child was born Windsor Street Halifax Ns Present address of Father Compton Avenue, Halifax, NS

Occupation of Father at Birth of child Presman Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Albert Garfield Burgess Address of Applicant 35 Marion Heights, Halifax, NS Date October 1956

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Albert GarfieldBurgess

Born at Windsor Street, Halifax in the County of Halifax

That Albert GarfieldBurgess Whose Birth is sought to be registered was

born at Windsor Street, Halifax Halifax County on January 1, 1923

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

His school record. (his mother) His army papers, etc.

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