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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000507

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clairmont AlonzoZwicker Sex Male

Date of Birth June 11, 1924 Place of Birth WilevilleCounty of Lunenburg

Name of Father Elam Alonzo Zwicker MAIDEN NAME of Mother Lydia A. Weagle

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

Residence of Father when child was born Wileville, Lunenburg Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Farmville, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Clairmont Zwicker Address of Applicant Milford Street, Milton, Queens Co., NS Date 21 July 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clairmont AlonzoZwicker

Born at Wileville in the County of Lunenburg

That Clairmont AlonzoZwicker Whose Birth is sought to be registered was

born at Wileville Lunenburg County on June 11, 1924

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

The family bible and my knowledge as his mother

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