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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000431

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frank WilliamPitts Sex Male

Date of Birth November 19, 1924 Place of Birth LiverpoolCounty of Queens

Name of Father William Albert Pitts MAIDEN NAME of Mother Adelaide Roy

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

Residence of Father when child was born Liverpool, Queens Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Queens Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Frank W. Pitts Address of Applicant Greenfield Park, Quebec Date 12 July 1974

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frank WilliamPitts

Born at Liverpool in the County of Queens

That Frank WilliamPitts Whose Birth is sought to be registered was

born at Liverpool Queens County on November 19, 1924

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

Certificate of Baptism

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