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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000287

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of May AdventDominey Sex

Date of Birth April 29, 1920 Place of Birth Fox PointCounty of Lunenburg

Name of Father Franklin Eugene Dominey MAIDEN NAME of Mother Mary Catherine Fleet

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

Residence of Father when child was born Fox Point Present address of Father deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Fox Point

Race Canadian Name and present address of Physician in attendance at birth Dr. Dabney, Chester (Now deceased)

Signature of Applicant May Kirby Address of Applicant Atlantic Avenue, Spryfield Date December 11, 1956

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of May AdventDominey

Born at Fox Point in the County of Lunenburg

That May AdventDominey Whose Birth is sought to be registered was

born at Fox Point Lunenburg County on April 29, 1920

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

Baptismal Certificate

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