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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100362

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 6, 1920 Place of Birth Pleasant RiverCounty of Lunenburg

Name of Father Harold Leslie Fancy MAIDEN NAME of Mother Lila Hildred Hamm

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

Residence of Father when child was born Pleasant River Present address of Father deceased

Occupation of Father at Birth of child Sectionman on Canadian National Railway Place of birth of Father Pleasant River

Race Name and present address of Physician in attendance at birth

Signature of Applicant Chester L. Fancy Address of Applicant Pleasant River Date April 1, 1986

Relationship of Applicant to child brother

AFFIDAVIT

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

Born at Pleasant River in the County of Lunenburg

That Bessie EmmaFancy Whose Birth is sought to be registered was

born at Pleasant River Lunenburg County on July 6, 1920

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

Brother of Bessie Emma Fancy Baptismal

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