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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000698

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Raymond AlexanderSimpson Sex Male

Date of Birth February 22, 1924 Place of Birth AmherstCounty of Cumberland

Name of Father Robert Simpson MAIDEN NAME of Mother Mary Thibodeau

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

Residence of Father when child was born Amherst, Cumberland Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Parrsboro, Cumberland Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Raymond A. Simpson Address of Applicant 18 Palmer Street, Amherst, Cumberland Co., NS Date 23 December 1980

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Raymond AlexanderSimpson

Born at Amherst in the County of Cumberland

That Raymond AlexanderSimpson Whose Birth is sought to be registered was

born at Amherst Cumberland County on February 22, 1924

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

Based on information I have always been told and that I have always used

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