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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000523

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lester WalterCross Sex Male

Date of Birth December 23, 1923 Place of Birth Conquerall MillsCounty of Lunenburg

Name of Father Otto Bordman Cross MAIDEN NAME of Mother Estelle Rosamund Bailey

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

Residence of Father when child was born Conquerall Mills Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Conquerall Mills

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lester W. Cross Address of Applicant 116 Dublin St. Bridgewater Date June 26, 1975

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lester WalterCross

Born at Conquerall Mills in the County of Lunenburg

That Lester WalterCross Whose Birth is sought to be registered was

born at Conquerall Mills Lunenburg County on December 23, 1923

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

Certification letter from Mother Certificate of Baptism

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