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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100307

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lillian EdnaJackson Sex Female

Date of Birth August 16, 1920 Place of Birth Spry HarbourCounty of Halifax

Name of Father Hilton Jackson MAIDEN NAME of Mother Ethel Josey

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

Residence of Father when child was born Spry Harbour Present address of Father deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Spry Harbour

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lillian E. Myers Address of Applicant Lake Charlotte Date February 14, 1985

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lillian EdnaJackson

Born at Spry Harbour in the County of Halifax

That Lillian EdnaJackson Whose Birth is sought to be registered was

born at Spry Harbour Halifax County on August 16, 1920

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

Baptism Certificate

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