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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000669

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ethel RuthAusten Sex Female

Date of Birth May 24, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Violet Chase

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

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

Race Anglo-saxon Name and present address of Physician in attendance at birth

Signature of Applicant Ethel May Austen Address of Applicant Halifax Date February 1, 1974

Relationship of Applicant to child Adoptive mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ethel RuthAusten

Born at Halifax in the County of Halifax

That Ethel RuthAusten Whose Birth is sought to be registered was

born at Halifax Halifax County on May 24, 1920

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

A letter from the department of Social Services (attached hereto as Exhibit "A") certifying that the records of St. Joseph's Orphanage show Audrey Chase to have been born on that date.

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