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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000596

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Violet JaneRomans Sex Female

Date of Birth July 14, 1920 Place of Birth Hammonds PlainsCounty of Halifax

Name of Father Lewis Romans MAIDEN NAME of Mother Theresa Brunswick

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

Residence of Father when child was born Hammonds Plains Present address of Father deceased

Occupation of Father at Birth of child Mill Hand Place of birth of Father -

Race Scottish Name and present address of Physician in attendance at birth Mrs. L. Carlton, midwife

Signature of Applicant Violet J. Geizer Address of Applicant Hammonds Plains, Halifax Co. Date 15 June 1972

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Violet JaneRomans

Born at Hammonds Plains in the County of Halifax

That Violet JaneRomans Whose Birth is sought to be registered was

born at Hammonds Plains Halifax County on July 14, 1920

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

A Baptism card register at Sackville Rectory

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