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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000206

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frank LeoJollymore Sex Male

Date of Birth October 19, 1923 Place of Birth AmherstCounty of Cumberland

Name of Father John Francis Leo Jollymore MAIDEN NAME of Mother Ella May Rutledge

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 Chester Grant, Lunenburg Co., NS

Occupation of Father at Birth of child Carpenter Place of birth of Father New Ross, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Frank Jollymore Address of Applicant Chester Grant, Lunenburg Co., NS Date 22 September 1956

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frank LeoJollymore

Born at Amherst in the County of Cumberland

That Frank LeoJollymore Whose Birth is sought to be registered was

born at Amherst Cumberland County on October 19, 1923

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

I am his mother and the above is a true and correct statement. (Church record)

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