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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000211

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mildred RuthHollingsworth Sex Female

Date of Birth November 24, 1920 Place of Birth BlockhouseCounty of Lunenburg

Name of Father Arthur Lalane Hollingsworth MAIDEN NAME of Mother Lois Mae Joudrey

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

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

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

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

Signature of Applicant Mrs. Mildred Walters Address of Applicant Liverpool Date September 23, 1953

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mildred RuthHollingsworth

Born at Blockhouse in the County of Lunenburg

That Mildred RuthHollingsworth Whose Birth is sought to be registered was

born at Blockhouse Lunenburg County on November 24, 1920

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

I was there and assisted at the time of Birth (Census reports Baptism Certificate)

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