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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000781

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Glen Richard AllenWooddworth Sex Male

Date of Birth December 7, 1923 Place of Birth HemfordCounty of Lunenburg

Name of Father Oren Woodworth MAIDEN NAME of Mother Elretta Snyder

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

Residence of Father when child was born Hemford Lunenburg Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Hemford, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Glen Woodworth Address of Applicant RR #4, New Germany, Lunenburg Co., NS Date 4 June 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Glen Richard AllenWooddworth

Born at Hemford in the County of Lunenburg

That Glen Richard AllenWooddworth Whose Birth is sought to be registered was

born at Hemford Lunenburg County on December 7, 1923

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

I am the mother of Glen Richard Allen Woodworth and make oath that he was born at Hemford, NS. On December 7, 1923 and also find enclosed copy of baptism certificate.

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