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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000005

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Irving MalcolmFrancis Sex Male

Date of Birth March 10, 1924 Place of Birth YarmouthCounty of Yarmouth

Name of Father   MAIDEN NAME of Mother Vera Bernard

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Vera Francis Address of Applicant Yarmouth, NS Date 12 October 1946

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Irving MalcolmFrancis

Born at Yarmouth in the County of Yarmouth

That Irving MalcolmFrancis Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on March 10, 1924

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

I am his mother and have a personal knowledge of the date of his birth

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