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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000210

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ivan HaroldWamboldt Sex Male

Date of Birth April 17, 1924 Place of Birth CamperdownCounty of Lunenburg

Name of Father Harold Allen Wamboldt MAIDEN NAME of Mother Laura Zwicker

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

Residence of Father when child was born Camperdown, Lunenburg Co., NS Present address of Father Bridgewater, Lunenburg Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Camperdown, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ivan H. Wamboldt Address of Applicant RR #3, Bridgewater, Lunenburg Co., NS Date 10 July 1959

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ivan HaroldWamboldt

Born at Camperdown in the County of Lunenburg

That Ivan HaroldWamboldt Whose Birth is sought to be registered was

born at Camperdown Lunenburg County on April 17, 1924

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

That I have and am enclosing a transcript of the church record wherein my baptism was recorded

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