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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000042

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary AnnGillis Sex Female

Date of Birth August 14, 1920 Place of Birth JudiqueCounty of Inverness

Name of Father Archibald Gillis MAIDEN NAME of Mother Ann McDonald

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

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

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

Race Scottish Name and present address of Physician in attendance at birth deceased

Signature of Applicant Mary Ann Stavasius Address of Applicant 14 Hollis St. Halifax Date November 10, 1947

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary AnnGillis

Born at Judique in the County of Inverness

That Mary AnnGillis Whose Birth is sought to be registered was

born at Judique Inverness County on August 14, 1920

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

Baptismal record attached

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