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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

36800314

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Walter EdwardRogers Sex Male

Date of Birth August 30, 1924 Place of Birth YarmouthCounty of Yarmouth

Name of Father William Rozee Rogers MAIDEN NAME of Mother Elizabeth Evangeline Burrows

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

Residence of Father when child was born Yarmouth, NS Present address of Father

Occupation of Father at Birth of child Auto Mechanic Place of birth of Father Yarmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant W. R. Rogers Address of Applicant Yarmouth North, NS Date 22 September 1924

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Walter EdwardRogers

Born at Yarmouth in the County of Yarmouth

That Walter EdwardRogers Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on August 30, 1924

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

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