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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000195

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Irene EvaMansfield Sex Female

Date of Birth November 8, 1920 Place of Birth WestfieldCounty of Queens

Name of Father Melton D. Mansfield MAIDEN NAME of Mother Lilla Eva  Weare

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

Residence of Father when child was born Westfield Present address of Father Westfield (Deceased)

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

Race Anglo Saxon Name and present address of Physician in attendance at birth Dr. J.B. March

Signature of Applicant Lilla Eva Mansfield Address of Applicant South Brookfield Date September 4, 1952

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Irene EvaMansfield

Born at Westfield in the County of Queens

That Irene EvaMansfield Whose Birth is sought to be registered was

born at Westfield Queens County on November 8, 1920

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

As recorded on Family Record (Framed) (School record & census report)

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