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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600261

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen MaryKelly Sex Female

Date of Birth August 9, 1920 Place of Birth KentvilleCounty of Kings

Name of Father Walter Seymour Kelly MAIDEN NAME of Mother Harriett Essia Myles

Residence of Father when child was born Kentville, Kings Co. Present address of Father Kentville, Kings Co.

Occupation of Father at Birth of child Painter Place of birth of Father Grand Pre, Kings Co.

Race White Name and present address of Physician in attendance at birth Dr. H. B. Webster

Signature of Applicant - Address of Applicant - Date 17 November 1934

Relationship of Applicant to child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen MaryKelly

Born at Kentville in the County of Kings

That Helen MaryKelly Whose Birth is sought to be registered was

born at Kentville Kings County on August 9, 1920

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

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