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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000897

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of VincentRogers Sex Male

Date of Birth May 27, 1923 Place of Birth St. Margarets BayCounty of Halifax

Name of Father   MAIDEN NAME of Mother Ethel Rogers

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Vincent Rogers Address of Applicant RR #2, East Jeddore, Halifax Co., NS Date 27 June 1984

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of VincentRogers

Born at St. Margarets Bay in the County of Halifax

That VincentRogers Whose Birth is sought to be registered was

born at St. Margarets Bay Halifax County on May 27, 1923

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

Records of Halifax Infants Home in custody of Dept. of Social Services

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