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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000288

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Wilfred LeonardAtkins Sex Male

Date of Birth June 25, 1923 Place of Birth YarmouthCounty of Yarmouth

Name of Father Wilfred Leonard Atkins MAIDEN NAME of Mother Ann Cecilia Muise

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

Residence of Father when child was born Yarmouth Ns Present address of Father Preston, Ontario

Occupation of Father at Birth of child Place of birth of Father Shag Harbour, Shelburne Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ann C. M. Atkins Address of Applicant Preston, Ontario Date 28 May 1963

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Wilfred LeonardAtkins

Born at Yarmouth in the County of Yarmouth

That Wilfred LeonardAtkins Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on June 25, 1923

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

I am his mother. Baptism certificate shows name of child as Muise which was my maiden name.

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