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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91703407

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Regina MaeAtkinson Sex Female

Date of Birth June 26, 1920 Place of Birth Stoney IslandCounty of Shelburne

Name of Father Clifford David Atkinson MAIDEN NAME of Mother Daisy Mae Smith

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

Residence of Father when child was born Deceased March 1920 Present address of Father deceased

Occupation of Father at Birth of child Deceased at time of birth Place of birth of Father Clam Point, Shelburne Co.

Race Canadian Name and present address of Physician in attendance at birth Mrs. Rebecca Ross

Signature of Applicant Mrs. Daisy Atkinson Address of Applicant Stony Island, Shelburne Co. Date 20 September 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Regina MaeAtkinson

Born at Stoney Island in the County of Shelburne

That Regina MaeAtkinson Whose Birth is sought to be registered was

born at Stoney Island Shelburne County on June 26, 1920

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

Mother of Regina Mae Atkinson

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