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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100082

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary CarolineGilbert Sex

Date of Birth August 3, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father Eugene Daniel Gilbert MAIDEN NAME of Mother Mary Catherine Campbell

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

Residence of Father when child was born Windsor, Vermont, USA Present address of Father deceased

Occupation of Father at Birth of child Machine Laborer Place of birth of Father White River Junction, Vermont, USA

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Gilbert Katomski Address of Applicant 1 Cold Spring Hill Road, Huntington, New York, USA Date August 25, 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary CarolineGilbert

Born at Glace Bay in the County of Cape Breton

That Mary CarolineGilbert Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on August 3, 1920

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

My sister Mary G. Katomski was born while my mother Mary G. Gilbert with my sister, two brothers and myself were visiting her family during the summer of 1920 in Cape Breton

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