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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700005

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen FrancesClarke Sex Female

Date of Birth December 3, 1919 Place of Birth SydneyCounty of Cape Breton

Name of Father Joseph William Clarke MAIDEN NAME of Mother Catherine McPhee

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

Residence of Father when child was born Sydney Present address of Father 48 Mgaville St.

Occupation of Father at Birth of child Clerk Place of birth of Father Emerald Junction, PEI

Race Name and present address of Physician in attendance at birth Dr. J.G.B. Lynch

Signature of Applicant Joseph William Clarke Address of Applicant 48 Mgaville St., Sydney Date 28 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen FrancesClarke

Born at Sydney in the County of Cape Breton

That Helen FrancesClarke Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 3, 1919

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

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