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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000695

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rita ElizabethO'Neil Sex Female

Date of Birth March 1, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father Benedict Nicholas O'Neil MAIDEN NAME of Mother Mary Anne Cameron

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

Residence of Father when child was born Glace Bay Present address of Father deceased

Occupation of Father at Birth of child Merchant Place of birth of Father Glace Bay

Race Name and present address of Physician in attendance at birth

Signature of Applicant Rita Elizabeth O'Neil Ulrich Address of Applicant Dominion Date September 11, 1974

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rita ElizabethO'Neil

Born at Glace Bay in the County of Cape Breton

That Rita ElizabethO'Neil Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on March 1, 1920

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

Certificate from records of Immaculate Conception Parish, Bridgeport and personal knowledge passed on to me from my parents.

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