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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

63000394

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Fred ErlandHarris Sex Male

Date of Birth April 17, 1924 Place of Birth WindsorCounty of Hants

Name of Father Fred Erland Harris MAIDEN NAME of Mother Helen Decker

Residence of Father when child was born Windsor, Hants Co., NS Present address of Father Jordan Ferry, Shelburne Co., NS

Occupation of Father at Birth of child Fisherman Place of birth of Father Little River Harbour, Yarmouth Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Fred Earland Harris Address of Applicant Jordan Ferry, Shelburne Co., NS Date

Relationship of Applicant to child 5 October 1928

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Fred ErlandHarris

Born at Windsor in the County of Hants

That Fred ErlandHarris Whose Birth is sought to be registered was

born at Windsor Hants County on April 17, 1924

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

I am his father

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