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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91400225

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of FairlieCarmichael Sex Female

Date of Birth July 31, 1920 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father James Carmichael MAIDEN NAME of Mother Sybil Carmichael

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

Residence of Father when child was born Sydney, Cape Breton Co. Present address of Father

Occupation of Father at Birth of child Salesman Place of birth of Father Sydney, Cape Breton Co.

Race White Name and present address of Physician in attendance at birth Dr. Johnson, Sydney Mines, Cape Breton Co.

Signature of Applicant Sybil Carmichael Address of Applicant 149 Warren Street, Roxbury, Massachusetts Date 11 April 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of FairlieCarmichael

Born at Sydney Mines in the County of Cape Breton

That FairlieCarmichael Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on July 31, 1920

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

Mother

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