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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000034

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kathryn AlmaClarke Sex Female

Date of Birth February 7, 1920 Place of Birth GraftonCounty of Kings

Name of Father John Hopkins Clarke MAIDEN NAME of Mother Kate Evelyn Rocknell

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

Residence of Father when child was born Grafton Present address of Father Waterville

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

Race White Name and present address of Physician in attendance at birth Dr. H.E. Killiam, Woodville

Signature of Applicant John Hopkins Clarke Address of Applicant Waterville Date August 9, 1947

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kathryn AlmaClarke

Born at Grafton in the County of Kings

That Kathryn AlmaClarke Whose Birth is sought to be registered was

born at Grafton Kings County on February 7, 1920

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

I am her father and was present at the time of her birth

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