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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000384

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Florence EileenBartlett Sex

Date of Birth September 7, 1920 Place of Birth Kennetcook CornerCounty of Hants

Name of Father George Albert Bartlett MAIDEN NAME of Mother Ensilia McCulloch

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

Residence of Father when child was born Riverside Corner Present address of Father deceased

Occupation of Father at Birth of child Lumbering Place of birth of Father Truro

Race English Name and present address of Physician in attendance at birth Dr. O'Brien (Deceased)

Signature of Applicant Florence Eileen Bartlett (Bishop) Address of Applicant Kennetcook Date September 26, 1963

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Florence EileenBartlett

Born at Kennetcook Corner in the County of Hants

That Florence EileenBartlett Whose Birth is sought to be registered was

born at Kennetcook Corner Hants County on September 7, 1920

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

I have personally witnessed the Certificate of Baptism. I have personally witnessed the report of the School registers.

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