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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000756

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frank MelvinAcker Sex Male

Date of Birth November 10, 1923 Place of Birth ShelburneCounty of Shelburne

Name of Father Howard Melvin Acker MAIDEN NAME of Mother Dora Ann Gregory

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

Residence of Father when child was born Shelburne Ns Present address of Father Shelburne, NS

Occupation of Father at Birth of child Labourer Place of birth of Father Birchtown, Shelburne Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Melvin Acker Address of Applicant Box 376, Shelburne, NS Date 20 October 1979

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frank MelvinAcker

Born at Shelburne in the County of Shelburne

That Frank MelvinAcker Whose Birth is sought to be registered was

born at Shelburne Shelburne County on November 10, 1923

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

I am his mother. The baptism certificate is in your possession.

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