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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000831

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kathleen GenevaConn Sex

Date of Birth January 4, 1920 Place of Birth CherryfieldCounty of Lunenburg

Name of Father Perry R.  Conn MAIDEN NAME of Mother Ethel May Adams

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

Residence of Father when child was born Cherryfield Road Present address of Father deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Cherryfield

Race Name and present address of Physician in attendance at birth

Signature of Applicant Kathleen Geneva Whynot Address of Applicant RR 3, New Germany Date April 23, 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kathleen GenevaConn

Born at Cherryfield in the County of Lunenburg

That Kathleen GenevaConn Whose Birth is sought to be registered was

born at Cherryfield Lunenburg County on January 4, 1920

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

As told by my parents.

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