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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000394

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carl JosephHearn Sex Male

Date of Birth September 21, 1924 Place of Birth Rocky BayCounty of Richmond

Name of Father William H. Hearn MAIDEN NAME of Mother Elizabeth Mullins

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

Residence of Father when child was born Rocky Bay, Richmond Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Rocky Bay, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Carl Hearn Address of Applicant 165 Place D'Youville, Montreal, Quebec Date 14 May 1973

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carl JosephHearn

Born at Rocky Bay in the County of Richmond

That Carl JosephHearn Whose Birth is sought to be registered was

born at Rocky Bay Richmond County on September 21, 1924

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

I was at home and in the house at his birth and remember well as he is the youngest of the family. Baptismal certificate, seaman card, passport

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