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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000798

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gladys WinnifredRussell Sex Female

Date of Birth April 19, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Ernest Russell MAIDEN NAME of Mother Winnifred Evans

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

Residence of Father when child was born Halifax Present address of Father deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father Clam Harbour, Halifax Co.

Race Name and present address of Physician in attendance at birth

Signature of Applicant Gladys Grandy Address of Applicant 90 Sunnybrae Avenue, Halifax Date 10 September 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gladys WinnifredRussell

Born at Halifax in the County of Halifax

That Gladys WinnifredRussell Whose Birth is sought to be registered was

born at Halifax Halifax County on April 19, 1920

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

Baptismal record

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