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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000555

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James EpheramGodfrey Sex Male

Date of Birth December 27, 1923 Place of Birth Thomson StationCounty of Cumberland

Name of Father George Everett Forbes Godfrey MAIDEN NAME of Mother Vera Helen Lawrence

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

Residence of Father when child was born Thomson Station Cumberland Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Railway Section Man Place of birth of Father Thomson Station, Cumberland Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant James E. Godfrey Address of Applicant 6053 Coholan Street, Niagara Falls, Ontario Date 6 January 1976

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James EpheramGodfrey

Born at Thomson Station in the County of Cumberland

That James EpheramGodfrey Whose Birth is sought to be registered was

born at Thomson Station Cumberland County on December 27, 1923

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

Information given to me by my father and mother, now deceased. I have always celebrated and understood that I was born on December 27, 1923 and now confirmed by the School Registrar at Oxford Junction School Section and by the Census Records.

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