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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000837

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Phyllis NovellaWesley Sex

Date of Birth January 23, 1920 Place of Birth LiverpoolCounty of Queens

Name of Father Alberton Wesley MAIDEN NAME of Mother  Halfkenny

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

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

Occupation of Father at Birth of child Painter Place of birth of Father Liverpool

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Phyllis N. feener Address of Applicant Liverpool Date May 18, 1977

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Phyllis NovellaWesley

Born at Liverpool in the County of Queens

That Phyllis NovellaWesley Whose Birth is sought to be registered was

born at Liverpool Queens County on January 23, 1920

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

Leaf of the Family Bible and Baptism form.

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