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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000746

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Vera BerniceSmith Sex Female

Date of Birth August 27, 1920 Place of Birth Cape ForchueCounty of Yarmouth

Name of Father Gordon Daniel Smith MAIDEN NAME of Mother Abbie Ann Hunt

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

Residence of Father when child was born Cape Forchue Present address of Father deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Port Saxon

Race Name and present address of Physician in attendance at birth

Signature of Applicant Vera Bernice Smith Address of Applicant Clam Point Date September 16, 1975

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Vera BerniceSmith

Born at Cape Forchue in the County of Yarmouth

That Vera BerniceSmith Whose Birth is sought to be registered was

born at Cape Forchue Yarmouth County on August 27, 1920

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

I can solemnly say this affidavit is true as I was to her home the summer she was born with my son that was one year old at the time. - Benjamin Nickerson

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