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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100124

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alice LouiseNickerson Sex

Date of Birth September 23, 1920 Place of Birth The HawkCounty of Shelburne

Name of Father Frederick  Stoddard MAIDEN NAME of Mother Thelma Mae  Nickerson

Were the Parents married at the time of the Birth?

Residence of Father when child was born Lr. Charles Harbour Present address of Father deceased

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 Alice Louisa Nickerson Address of Applicant R.R. #1, Clarks Harbour, B0W 1P0 Date Hyne 11, 1981

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alice LouiseNickerson

Born at The Hawk in the County of Shelburne

That Alice LouiseNickerson Whose Birth is sought to be registered was

born at The Hawk Shelburne County on September 23, 1920

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

1. Statistics Canada Census Records. 2. Public Archives of Nova Scotia Record. 3. Two Hospital Records. 4. A Doctors Record.

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