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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000700

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Raymond AptChalloner Sex Male

Date of Birth August 1, 1923 Place of Birth DeerfieldCounty of Yarmouth

Name of Father William Challoner MAIDEN NAME of Mother Leta Sabean

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

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

Occupation of Father at Birth of child Woodsman Place of birth of Father Deerfield, Yarmouth Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Titus Challoner Address of Applicant Sluice Point, Yarmouth Co., NS Date 28 February 1979

Relationship of Applicant to child Uncle

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Raymond AptChalloner

Born at Deerfield in the County of Yarmouth

That Raymond AptChalloner Whose Birth is sought to be registered was

born at Deerfield Yarmouth County on August 1, 1923

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

I am Raymond Apt Challoner's uncle and lived less that 1/2 mile from where he was born and remember when he was born. I was 17 years of age at the time.

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