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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000190

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frederick JohnSchultz Sex Male

Date of Birth June 8, 1924 Place of Birth HalifaxCounty of Halifax

Name of Father Walter James Schultz MAIDEN NAME of Mother Dolorosa Sharpe

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

Residence of Father when child was born Gottingen Street, Halifax, NS Present address of Father Deceased

Occupation of Father at Birth of child Baggage Porter, Canadian National Railway Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dolorosa Rogers Address of Applicant 30 Russell Street, Dartmouth, NS Date 8 April 1957

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frederick JohnSchultz

Born at Halifax in the County of Halifax

That Frederick JohnSchultz Whose Birth is sought to be registered was

born at Halifax Halifax County on June 8, 1924

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

(Baptism certificate and National registration record) Records appearing in Family Bible indicate the above information. Further confirmation is to be found in Baptismal records in my possession

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