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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000755

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ruth EileenFaulkenham Sex Female

Date of Birth April 7, 1920 Place of Birth DayspringCounty of Lunenburg

Name of Father Howard Faulkenham MAIDEN NAME of Mother Olive Wagner

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

Residence of Father when child was born Dayspring Present address of Father Lunenburg

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant John H. Wagner Address of Applicant Bridgewater Date January 15, 1976

Relationship of Applicant to child son

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ruth EileenFaulkenham

Born at Dayspring in the County of Lunenburg

That Ruth EileenFaulkenham Whose Birth is sought to be registered was

born at Dayspring Lunenburg County on April 7, 1920

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

Baptism

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