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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000272

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of JamesRogers Sex Male

Date of Birth October 1, 1924 Place of Birth New HavenCounty of Victoria

Name of Father William H. Rogers MAIDEN NAME of Mother Katie Anne MacLeod

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

Residence of Father when child was born New Haven, Victoria Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Seal Islands, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Alex MacDonald Address of Applicant New Haven, Victoria Co., NS Date 12 May 1964

Relationship of Applicant to child Sister (to James Rogers)

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of JamesRogers

Born at New Haven in the County of Victoria

That JamesRogers Whose Birth is sought to be registered was

born at New Haven Victoria County on October 1, 1924

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

Record at home - Baptism Certificate James Rogers - born October 1st, 1924 - son of William H. Rogers and Katie Anne MacLeod

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