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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000162

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen EmmaMarriott Sex Female

Date of Birth May 17, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Edward Marriott MAIDEN NAME of Mother Gertrude Richardson

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

Residence of Father when child was born 96 Allen St. Halifax Present address of Father 30 Yukon St. Halifax

Occupation of Father at Birth of child Confectioner Place of birth of Father Harrietsfield

Race French-Norman Name and present address of Physician in attendance at birth Dr. Miller deceased

Signature of Applicant Helen E. M. Warren Address of Applicant 30 Yukon St. Halifax Date June 29, 1951

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen EmmaMarriott

Born at Halifax in the County of Halifax

That Helen EmmaMarriott Whose Birth is sought to be registered was

born at Halifax Halifax County on May 17, 1920

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

Certificate of Baptism attached

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