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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500051

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Luella MarieLatta Sex Female

Date of Birth October 7, 1919 Place of Birth PugwashCounty of Cumberland

Name of Father Amos Clarence Latta MAIDEN NAME of Mother Myrtle Isadora Teed

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

Residence of Father when child was born Pugwash Junction Present address of Father

Occupation of Father at Birth of child Carpenter Place of birth of Father Pugwash

Race Name and present address of Physician in attendance at birth Dr. W.V. Goodwin

Signature of Applicant Amos Latta Address of Applicant Pugwash Junction Date 08 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Luella MarieLatta

Born at Pugwash in the County of Cumberland

That Luella MarieLatta Whose Birth is sought to be registered was

born at Pugwash Cumberland County on October 7, 1919

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

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