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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000515

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Herman CecilCox Sex Male

Date of Birth June 5, 1924 Place of Birth Upper Big TracadieCounty of Guysborough

Name of Father Garnet Cox MAIDEN NAME of Mother Delia Ash

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

Residence of Father when child was born Upper Big Tracadie, Guysborough Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father West Indies

Race Name and present address of Physician in attendance at birth

Signature of Applicant Herman Cecil Cox Address of Applicant RR #1, Armedale Street, Upper Big Tracadie, Guysborough Co., NS Date 26 June 1976

Relationship of Applicant to child child is the applicant

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Herman CecilCox

Born at Upper Big Tracadie in the County of Guysborough

That Herman CecilCox Whose Birth is sought to be registered was

born at Upper Big Tracadie Guysborough County on June 5, 1924

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

I lived close to the home of Mr. Cox's parents and remember well Mr. Cox being a small baby and I remember when he first attended school

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