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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000666

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Annie MildredFraser Sex Female

Date of Birth November 13, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father John David Fraser MAIDEN NAME of Mother Ethel Simmons

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

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

Occupation of Father at Birth of child Steel worker Place of birth of Father Pictou County

Race Scottish Name and present address of Physician in attendance at birth Dr. Raymond Ross, Sydney

Signature of Applicant Mrs. Annie Allen Address of Applicant Sydney Date January 15, 1974

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Annie MildredFraser

Born at Sydney in the County of Cape Breton

That Annie MildredFraser Whose Birth is sought to be registered was

born at Sydney Cape Breton County on November 13, 1920

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

The Register General's Office have on file an extract from a common school register indicating that I was born on November 13, 1920. They also have a report from the 1931 census which tends to support that date and I also agree with the date of November 13, 1920.

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