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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000785

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clara Maude KathleenVaughan Sex Female

Date of Birth June 28, 1920 Place of Birth GaspereauxCounty of Kings

Name of Father Frederick Lester Vaughan MAIDEN NAME of Mother Carrie Maude Skaling

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

Residence of Father when child was born Gaspereaux Present address of Father Greenwich

Occupation of Father at Birth of child Farm labourer Place of birth of Father Bishopville

Race caucasian Name and present address of Physician in attendance at birth Dr. Elliott, Wolfville

Signature of Applicant Carrie Maude Vaughan Address of Applicant Greenwich Date July 1974

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clara Maude KathleenVaughan

Born at Gaspereaux in the County of Kings

That Clara Maude KathleenVaughan Whose Birth is sought to be registered was

born at Gaspereaux Kings County on June 28, 1920

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

Port Williams, Kings County and Marriage Certificate

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