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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000670

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carl MauriceSpicer Sex Male

Date of Birth September 8, 1923 Place of Birth PlymouthCounty of Yarmouth

Name of Father Penn Spicer MAIDEN NAME of Mother Adele Monique Pothier

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Yarmouth Ns Present address of Father Deceased

Occupation of Father at Birth of child Stipendiary Magistrate Place of birth of Father Kirk Malew, Isle of Man

Race Name and present address of Physician in attendance at birth

Signature of Applicant C. Spicer Address of Applicant 1020 Surfside Place, Sidney, British Columbia Date 11 August 1978

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carl MauriceSpicer

Born at Plymouth in the County of Yarmouth

That Carl MauriceSpicer Whose Birth is sought to be registered was

born at Plymouth Yarmouth County on September 8, 1923

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

Birth and baptism certificate attached, registering baptism on September 19, 1923

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