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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500182

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary EvlynRafuse Sex Female

Date of Birth December 13, 1919 Place of Birth AmherstCounty of Cumberland

Name of Father Nathan Rafuse MAIDEN NAME of Mother Alva Henwood

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

Residence of Father when child was born Amherst Present address of Father 28 Chamberlain St.

Occupation of Father at Birth of child Labourer Place of birth of Father Canning

Race Name and present address of Physician in attendance at birth Dr. B.E. Goodwin

Signature of Applicant Alva Rafuse Address of Applicant 28 Chamberlain St., Amherst Date 10 January 1920

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary EvlynRafuse

Born at Amherst in the County of Cumberland

That Mary EvlynRafuse Whose Birth is sought to be registered was

born at Amherst Cumberland County on December 13, 1919

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

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