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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000599

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anna JaneMahoney Sex Female

Date of Birth July 11, 1920 Place of Birth StellartonCounty of Pictou

Name of Father Matthew Mahoney MAIDEN NAME of Mother Margaret White

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

Residence of Father when child was born Stellarton, Pictou Co. Present address of Father deceased

Occupation of Father at Birth of child Stationary Engineer Place of birth of Father Stellarton, Pictou Co.

Race Irish, French Name and present address of Physician in attendance at birth Dr. G. W. Whitman

Signature of Applicant Anna Jane Mahoney Address of Applicant 294 South Foord Street, Stellarton, Pictou Co. Date 12 July 1972

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anna JaneMahoney

Born at Stellarton in the County of Pictou

That Anna JaneMahoney Whose Birth is sought to be registered was

born at Stellarton Pictou County on July 11, 1920

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

Baptismal certificate

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