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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90501432

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Beverly ByrneHertle Sex Female

Date of Birth May 31, 1920 Place of Birth WoodsideCounty of Halifax

Name of Father James Edward Lewis Hertle MAIDEN NAME of Mother Mary Jane Niforth

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

Residence of Father when child was born Woodside, Dartmouth, Halifax Co. Present address of Father 576 Sicard Street, Montreal, Quebec

Occupation of Father at Birth of child Carpenter Place of birth of Father Halifax

Race Irish Name and present address of Physician in attendance at birth Dr. Byrne, Dartmouth

Signature of Applicant Mary Jane Hertle Address of Applicant 576 Sicard Street, Montreal, Quebec Date 6 March 1940

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Beverly ByrneHertle

Born at Woodside in the County of Halifax

That Beverly ByrneHertle Whose Birth is sought to be registered was

born at Woodside Halifax County on May 31, 1920

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

I am his mother

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