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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000911

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary Ann MaudGrady Sex Female

Date of Birth April 4, 1920 Place of Birth St. Francis HarbourCounty of Guysborough

Name of Father James William Grady MAIDEN NAME of Mother Louise  O'Slattery

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

Residence of Father when child was born St. Francis Harbour Present address of Father deceased

Occupation of Father at Birth of child Merchant Place of birth of Father St. Francis Harbour

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Ann Maud Wall Address of Applicant St. John's, Newfoundland Date May 8, 1978

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary Ann MaudGrady

Born at St. Francis Harbour in the County of Guysborough

That Mary Ann MaudGrady Whose Birth is sought to be registered was

born at St. Francis Harbour Guysborough County on April 4, 1920

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

My Baptismal Certificate which you are holding as Class "A" evidence

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