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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000487

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clyde LouisMyers Sex Male

Date of Birth October 6, 1924 Place of Birth Eastern PassageCounty of Halifax

Name of Father Charles Myers MAIDEN NAME of Mother Clara Foster

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

Residence of Father when child was born Eastern Passage, Halifax Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Storekeeper Place of birth of Father Eastern Passage, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Maxine Myers Address of Applicant Eastern Passage, Halifax Co., NS Date 26 January 1976

Relationship of Applicant to child Wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clyde LouisMyers

Born at Eastern Passage in the County of Halifax

That Clyde LouisMyers Whose Birth is sought to be registered was

born at Eastern Passage Halifax County on October 6, 1924

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

Baptismal record Marriage record

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