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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600981

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jessie AnnRoberts Sex Female

Date of Birth November 27, 1920 Place of Birth BucklawCounty of Victoria

Name of Father John Wesley Roberts MAIDEN NAME of Mother Christy Ann McLeod

Residence of Father when child was born Bucklaw, Victoria Co. Present address of Father Bucklaw, Victoria Co.

Occupation of Father at Birth of child Farming Place of birth of Father Boston, Massachusetts

Race Anglo Saxon Name and present address of Physician in attendance at birth Dr. John A. McIvor, Vancouver, BC

Signature of Applicant John Wesley Roberts Address of Applicant Bucklaw, Victoria Co. Date 2 July 1936

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jessie AnnRoberts

Born at Bucklaw in the County of Victoria

That Jessie AnnRoberts Whose Birth is sought to be registered was

born at Bucklaw Victoria County on November 27, 1920

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

That I was present in the house the day of her birth also that the date of said birth was recorded in the family bible.

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