State of North Carolina

Page No. 159

STATE BOARD OF HEALTH

OFFICE OF VITAL STATISTICS

NAME AT BIRTH: Havannah Fred HONEYCUTT

Date of Birth: October 27th, 1900

Sex. Male     Birthplace. Concord     County. Cabarrus

FULL NAME of Father: Adam HONEYCUTT

Color or Race. White  BIRTHPLACE.  North Carolina

MAIDEN NAME of Mother.  Hattie OVERCASH

Color or Race.  White    BIRTHPLACE.  North Carolina

I hereby declare under oath that the above statements are true to the best of my knowledge.

SIGNATURE OF REGISTRANT OR REPRESENTATIVE.  Havannah Fred HONEYCUTT

SWORN TO AND SUBSCRIBED BEFORE ME THIS 25 DAY OF July, 1961.

SEAL. Feb. 6, 1962 {Date Notary Public Commission Expires}

Charles C. CULPEPPER Jr., Notary Public or Register of Deeds.

I hereby certify that the evidence described above was examined by me or my agent.  

John R. BOGER, Register of Deeds.

Date. 8-4-61     SIGNATURE.   Myrtle M. FURR, Deputy, Register of Deeds.

I certify that the above named person has no prior birth certificate on file in this office.

Date filed.  Aug. 8, 1961    Charles R. COUNCIL, Chief, Office of Vital Statistics.

I, William B. BOGER, Register of Deeds and keeper of Vital Statistics for Cabarrus County, N.C. hereby certify that this a true and correct copy of Delayed Birth Certificate as found in book 16 page 159.  Given under my hand and official seal this 10 day of August 1961.    William B. BOGER, Deputy Register of Deeds