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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000757

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Isabell CatherineHart Sex Female

Date of Birth October 14, 1920 Place of Birth Middle RiverCounty of Victoria

Name of Father John Hart MAIDEN NAME of Mother Agnes Campbell Nicholson

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

Residence of Father when child was born Middle River Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Middle River

Race Name and present address of Physician in attendance at birth

Signature of Applicant Isabell Catherine MacLean Address of Applicant Sydney Date January 26, 1976

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Isabell CatherineHart

Born at Middle River in the County of Victoria

That Isabell CatherineHart Whose Birth is sought to be registered was

born at Middle River Victoria County on October 14, 1920

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

I am the mother of the said Isabell Catherine Hart - Agnes Hart

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