Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Jack Haayer death at South Waterville, Kings County on September 13, 1971
Male Death Registration: Year: 1971 number: 5528
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005528
1. PLACE OF DEATH County of Kings If in City or Town South Waterville
3. PRINT NAME OF DECEASED Haayer, Jack
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Dutch
7. Single, Married
married
8. BIRTHPLACE Enkhuisen, Holland
9. DATE OF BIRTH 8 28, 1931
10. AGE in Years40 Months Days15 | hrs or mins
11. Trade or profession Farmer
12. Kind of industry Farming
13. Date last worked 1971 14. Total years
15. If married name of spouse Sietie Andringa
16. NAME of Father John Haayer
17. BIRTHPLACE Holland
18. NAME of Mother Dirkje Jangejeugd
19. BIRTHPLACE Holland
20. Signature of Informant George Haayer
address Berwick
Relationship to deceased Brother
21. Place of burial Berwick
Date of burial September 17, 1971
22. Undertaker H.C. Lindsay Funeral Homes Ltd., Berwick
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 13, 1971
CAUSE OF DEATH
(a) Asphyxia
(b) Drowning
(c)
other Accident: tractor went off road overturned in 4 ft of water.
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