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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000335

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean RosalindMelvin Sex Female

Date of Birth January 21, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Jarvis Banford Melvin MAIDEN NAME of Mother Victoria Harnish

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

Residence of Father when child was born Stairs Street, Halifax Present address of Father Purcell's Cove, Halifax Co.

Occupation of Father at Birth of child Shipper Place of birth of Father

Race English Name and present address of Physician in attendance at birth Dr. Graham, Coburn Road, Halifax

Signature of Applicant Frederick Merle Oxner Address of Applicant Purcells Cove, Halifax Co. Date 6 January 1961

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean RosalindMelvin

Born at Halifax in the County of Halifax

That Jean RosalindMelvin Whose Birth is sought to be registered was

born at Halifax Halifax County on January 21, 1920

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

Baptism certificate

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