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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000783

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Evelyn PaulineCorkum Sex Female

Date of Birth May 23, 1920 Place of Birth Feltzen SouthCounty of Lunenburg

Name of Father Wilbert J.  Corkum MAIDEN NAME of Mother Jean Elizabeth Jinck

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

Residence of Father when child was born Feltzen South Present address of Father deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Feltzen South

Race Name and present address of Physician in attendance at birth

Signature of Applicant James G. Lloyd Address of Applicant Lockeport Date June 4, 1976

Relationship of Applicant to child husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Evelyn PaulineCorkum

Born at Feltzen South in the County of Lunenburg

That Evelyn PaulineCorkum Whose Birth is sought to be registered was

born at Feltzen South Lunenburg County on May 23, 1920

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

Certificate of Baptism

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