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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000806

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carroll WilliamChapman Sex Male

Date of Birth August 23, 1923 Place of Birth Chapman SettlementCounty of Cumberland

Name of Father Orrin Chapman MAIDEN NAME of Mother Myrtle Edith Finley

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

Residence of Father when child was born Chapman Settlement Cumberland Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Lumbering, Blacksmith Place of birth of Father Chapman Settlement, Cumberland Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant C. Chapman Address of Applicant RR #1, Debert, Colchester Co., NS Date 26 March 1981

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carroll WilliamChapman

Born at Chapman Settlement in the County of Cumberland

That Carroll WilliamChapman Whose Birth is sought to be registered was

born at Chapman Settlement Cumberland County on August 23, 1923

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

Memory of place and approximate time of birth. Full knowledge of and relationship to the family. Record and date of birth listed in the Brownville Genealogical Records.

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