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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000508

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of WalterRiley Sex Male

Date of Birth December 25, 1924 Place of Birth Cherry BrookCounty of Halifax

Name of Father Arthur Riley MAIDEN NAME of Mother Lena Cain

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

Residence of Father when child was born Cherry Brook, Halifax Co., NS Present address of Father Cherry Brook, Halifax Co., NS

Occupation of Father at Birth of child Self Employed Place of birth of Father Cherry Brook, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Grant Burley Address of Applicant 29 Prescott Drive, Dartmouth, NS Date 3 August 1976

Relationship of Applicant to child None

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of WalterRiley

Born at Cherry Brook in the County of Halifax

That WalterRiley Whose Birth is sought to be registered was

born at Cherry Brook Halifax County on December 25, 1924

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

School extract and census

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