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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000835

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frederick CollinsGoodwin Sex Male

Date of Birth March 13, 1923 Place of Birth Jordan FallsCounty of Shelburne

Name of Father Frederick Collins Goodwin MAIDEN NAME of Mother Cassie Drucella Brown

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 Fisherman Place of birth of Father Pubnico, Yarmouth Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Fred C. Goodwin Address of Applicant Reids Hill, Shelburne, NS Date 15 February 1980

Relationship of Applicant to child I am the child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frederick CollinsGoodwin

Born at Jordan Falls in the County of Shelburne

That Frederick CollinsGoodwin Whose Birth is sought to be registered was

born at Jordan Falls Shelburne County on March 13, 1923

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

From my early school records and from census reports and from my parents always celebrating my birthday (and date) as given.

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