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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000939

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Joseph RaymondRogers Sex Male

Date of Birth July 2, 1923 Place of Birth West ArichatCounty of Richmond

Name of Father Hanore Rogers MAIDEN NAME of Mother Alice Forgeron

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

Residence of Father when child was born West Arichat Richmond Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father West Arichat, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Raymond Rogers Address of Applicant West Arichat, Richmond Co., NS Date 25 September 1985

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Joseph RaymondRogers

Born at West Arichat in the County of Richmond

That Joseph RaymondRogers Whose Birth is sought to be registered was

born at West Arichat Richmond County on July 2, 1923

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

Official records here in Immaculate Conception Parish, West Arichat, registered four days after birth.

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