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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100029

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Doris ElizabethBailey Sex Female

Date of Birth March 4, 1920 Place of Birth LequilleCounty of Annapolis

Name of Father   MAIDEN NAME of Mother Laura Mae Bailey

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Doris Elizabeth Peters Barton Address of Applicant Granville Ferry Date August 27, 1979

Relationship of Applicant to child applicant

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Doris ElizabethBailey

Born at Lequille in the County of Annapolis

That Doris ElizabethBailey Whose Birth is sought to be registered was

born at Lequille Annapolis County on March 4, 1920

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

I am the mother (natural) of Doris Elizabeth Bailey. - Laura Mae Peters

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