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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800017

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marion WhelminaBaker Sex

Date of Birth July 5, 1920 Place of Birth MargaretsvilleCounty of Kings

Name of Father Ruman S. Baker MAIDEN NAME of Mother Addie Goucher

Residence of Father when child was born Margaretsville Present address of Father West Acton, Massachusetts, USA

Occupation of Father at Birth of child Farmer Place of birth of Father

Race White Name and present address of Physician in attendance at birth M.E. Devine, M.D., Kingston

Signature of Applicant Mrs. Addie Baker Address of Applicant West Acton, Massachusetts, USA Date April 24, 1944

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marion WhelminaBaker

Born at Margaretsville in the County of Kings

That Marion WhelminaBaker Whose Birth is sought to be registered was

born at Margaretsville Kings County on July 5, 1920

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

I am the mother and solemnly swear that she is my child.

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