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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000638

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gladys SelinaRoy Sex Female

Date of Birth May 6, 1920 Place of Birth North RiverCounty of Colchester

Name of Father Roland  Roy MAIDEN NAME of Mother Effie W. Nelson

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

Residence of Father when child was born North River Present address of Father Truro

Occupation of Father at Birth of child Teamster Place of birth of Father Liverpool

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

Signature of Applicant Effie M. Roy Address of Applicant Truro Date May 12, 1973

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gladys SelinaRoy

Born at North River in the County of Colchester

That Gladys SelinaRoy Whose Birth is sought to be registered was

born at North River Colchester County on May 6, 1920

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

1. Entry in Family Bible 2. Certificate of Baptism 3. I am the mother of Gladys Selina Roy, who was born at North River, Colchester County

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