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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000385

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ralph LouisWaterman Sex Male

Date of Birth July 14, 1924 Place of Birth Pleasant RiverCounty of Queens

Name of Father Ralph Lee Waterman MAIDEN NAME of Mother Eva Waterman

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

Residence of Father when child was born Pleasant River, Queens Co., NS Present address of Father Pleasant River, Queens Co., NS

Occupation of Father at Birth of child Labourer Place of birth of Father Pleasant River, Queens Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ralph Louis Waterman Address of Applicant South Brookfield, Queens Co., NS Date 8 March 1973

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ralph LouisWaterman

Born at Pleasant River in the County of Queens

That Ralph LouisWaterman Whose Birth is sought to be registered was

born at Pleasant River Queens County on July 14, 1924

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

National Registration Extract from Family Bible

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