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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

36800318

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harris RoySmith Sex Male

Date of Birth August 9, 1924 Place of Birth SalemCounty of Yarmouth

Name of Father Earl Aubury Smith MAIDEN NAME of Mother Alma Carrie MacGray

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father Lynn, Massachusetts

Race Name and present address of Physician in attendance at birth

Signature of Applicant Earl A. Smith Address of Applicant Salem, Yarmouth Co., NS Date 9 August 1924

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harris RoySmith

Born at Salem in the County of Yarmouth

That Harris RoySmith Whose Birth is sought to be registered was

born at Salem Yarmouth County on August 9, 1924

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

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