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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000547

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Charles PatrickCarvery Sex Male

Date of Birth October 21, 1924 Place of Birth AfricvilleCounty of Halifax

Name of Father Daniel Carvery MAIDEN NAME of Mother Beatrice Flint

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

Residence of Father when child was born Africville, Halifax, NS Present address of Father Deceased

Occupation of Father at Birth of child Canadian National Railway employee Place of birth of Father Africville, Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Patrick C. Carvery Address of Applicant 306 rue Theoret, Saint-Eustache, Quebec Date July 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Charles PatrickCarvery

Born at Africville in the County of Halifax

That Charles PatrickCarvery Whose Birth is sought to be registered was

born at Africville Halifax County on October 21, 1924

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

As told by my parents and confirmed correct through school records and the 1941 census, showing the surname incorrectly

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