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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000446

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Naomi King Sex Female

Date of Birth December 15, 1920 Place of Birth North SydneyCounty of Cape Breton

Name of Father William Thomas King MAIDEN NAME of Mother Elizabeth Sarah Arnold

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

Residence of Father when child was born North Sydney Present address of Father deceased

Occupation of Father at Birth of child Sea Captain Place of birth of Father Burnt Islands, Newfoundland

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

Signature of Applicant Naomi K. Nielson Address of Applicant Medicine Hat Date March 10, 1967

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Naomi King

Born at North Sydney in the County of Cape Breton

That Naomi King Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on December 15, 1920

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

Information received from my parents while living

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