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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

62600322

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carl RobieTompkins Sex Male

Date of Birth December 26, 1924 Place of Birth North East MargareeCounty of Inverness

Name of Father Leo Tompkins MAIDEN NAME of Mother Ada Esther McPherson

Residence of Father when child was born North East Margaree, Inverness Co. Present address of Father Waltham, Massachusetts

Occupation of Father at Birth of child Farmer Place of birth of Father North East Margaree, Inverness Co.

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Leo Tompkins Address of Applicant North East Margaree, Inverness Co., NS Date 25 August 1926

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carl RobieTompkins

Born at North East Margaree in the County of Inverness

That Carl RobieTompkins Whose Birth is sought to be registered was

born at North East Margaree Inverness County on December 26, 1924

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

I, Mrs. Leo Tompkins, do solemnly declare above statements true and correct

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