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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000985

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bessie AdriannaFletcher Sex Female

Date of Birth December 26, 1920 Place of Birth South OhioCounty of Yarmouth

Name of Father Everett Fletcher MAIDEN NAME of Mother Emma Jenness

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

Residence of Father when child was born South Ohio Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father South Ohio

Race Name and present address of Physician in attendance at birth

Signature of Applicant Bessie A. Blaunett Address of Applicant South Ohio Date April 10, 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bessie AdriannaFletcher

Born at South Ohio in the County of Yarmouth

That Bessie AdriannaFletcher Whose Birth is sought to be registered was

born at South Ohio Yarmouth County on December 26, 1920

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

School Record (as enclosed)

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