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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000912

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Evelyn JaneHorne Sex Female

Date of Birth July 11, 1920 Place of Birth MiraCounty of Cape Breton

Name of Father Samuel Horne MAIDEN NAME of Mother Margaret Grant

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

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Nova Scotia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ethel Elizabeth Horne Address of Applicant Donkin Date May 6, 1978

Relationship of Applicant to child sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Evelyn JaneHorne

Born at Mira in the County of Cape Breton

That Evelyn JaneHorne Whose Birth is sought to be registered was

born at Mira Cape Breton County on July 11, 1920

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

I am an older sister of Evelyn Jane Horne and confirm particulars of fact and date of her birth as stated above from my earliest recollection of our family.

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