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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000760

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of William IsaacBrown Sex Male

Date of Birth December 21, 1923 Place of Birth East Jordan FallsCounty of Shelburne

Name of Father William Henly Brown MAIDEN NAME of Mother Carrie Belle Matthews

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

Residence of Father when child was born Jordan Falls Shelburne Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Worked in Saw Mill Place of birth of Father Jordan Falls, Shelburne Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Carrie Belle Hartley Address of Applicant Jordan Falls, Shelburne Co., NS Date 10 November 1979

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of William IsaacBrown

Born at East Jordan Falls in the County of Shelburne

That William IsaacBrown Whose Birth is sought to be registered was

born at East Jordan Falls Shelburne County on December 21, 1923

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

My knowledge is that I remember William Isaac Brown's father William Henly Brown before he was married and I know when William Isaac Brown was born on December 21, 1923.

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