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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000020

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rita IsobelClarke Sex Female

Date of Birth December 20, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Lanies Clarke MAIDEN NAME of Mother Mary A. Gillis

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

Residence of Father when child was born Sydney Present address of Father deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Newfoundland

Race English Name and present address of Physician in attendance at birth Dr. Ross, Sydney

Signature of Applicant Mrs. Mary Collins Address of Applicant 12 Manse St. Sydney Date August 8, 1946

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rita IsobelClarke

Born at Sydney in the County of Cape Breton

That Rita IsobelClarke Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 20, 1920

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

I am the mother of Rita Isobel Clarke and have certificate of birth from Church Records

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