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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500130

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Tillie May CatherineSullivan Sex Female

Date of Birth November 28, 1919 Place of Birth WallaceCounty of Cumberland

Name of Father Roy Sullivan MAIDEN NAME of Mother Margaret Agatha Brennan

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

Residence of Father when child was born Wallace Bridge Present address of Father

Occupation of Father at Birth of child Farmer Place of birth of Father Tangier

Race Name and present address of Physician in attendance at birth Dr. F.D. Chairman

Signature of Applicant Roy Sullivan Address of Applicant Wallace Bridge Date 05 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Tillie May CatherineSullivan

Born at Wallace in the County of Cumberland

That Tillie May CatherineSullivan Whose Birth is sought to be registered was

born at Wallace Cumberland County on November 28, 1919

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

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