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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90701017

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Merton KennethSibbine Sex Male

Date of Birth December 22, 1920 Place of Birth GraywoodCounty of Annapolis

Name of Father Harris gordon Sibbine MAIDEN NAME of Mother Daisy Iola Wright

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

Residence of Father when child was born Graywood, Annapolis Co. Present address of Father Graywood, Annapolis Co.

Occupation of Father at Birth of child Labourer Place of birth of Father Graywood, Annapolis Co.

Race White Name and present address of Physician in attendance at birth Dr. Augustus Robinson, Annapolis

Signature of Applicant Mrs. Daisy Sibbins Address of Applicant Graywood, Annapolis Co. Date 24 June 1937

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Merton KennethSibbine

Born at Graywood in the County of Annapolis

That Merton KennethSibbine Whose Birth is sought to be registered was

born at Graywood Annapolis County on December 22, 1920

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

I being the mother of the child

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