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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200508

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Olive Evelyn WinifredCousins Sex Female

Date of Birth December 30, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Arthur Victor Cousins MAIDEN NAME of Mother Rose Elizabeth Woods

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

Residence of Father when child was born Halifax Present address of Father

Occupation of Father at Birth of child Engineer Place of birth of Father Channel, Newfoundland

Race Name and present address of Physician in attendance at birth Mrs. Kelly

Signature of Applicant Arthur V. Cousins Address of Applicant Halifax Date 21 February1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Olive Evelyn WinifredCousins

Born at Halifax in the County of Halifax

That Olive Evelyn WinifredCousins Whose Birth is sought to be registered was

born at Halifax Halifax County on December 30, 1919

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

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