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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500217

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy AgnesHeap Sex Female

Date of Birth December 27, 1919 Place of Birth Joggins MinesCounty of Cumberland

Name of Father Ernest Heap MAIDEN NAME of Mother Lily Agnes Mansell

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

Residence of Father when child was born Joggins Mines Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Derby, England

Race Name and present address of Physician in attendance at birth Dr. McLeod

Signature of Applicant Ernest Heaps Address of Applicant Joggins Mines Date 25 January 1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy AgnesHeap

Born at Joggins Mines in the County of Cumberland

That Dorothy AgnesHeap Whose Birth is sought to be registered was

born at Joggins Mines Cumberland County on December 27, 1919

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

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