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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700122

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Selena MayKing Sex Female

Date of Birth December 15, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father William Thomas King MAIDEN NAME of Mother Lorena Mercer

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

Residence of Father when child was born Glace Bay Present address of Father New Aberdeen

Occupation of Father at Birth of child Miner Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth Mrs. Bishop, nurse

Signature of Applicant Lorena King Address of Applicant New Aberdeen, Glace Bay Date 22 January 1920

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Selena MayKing

Born at Glace Bay in the County of Cape Breton

That Selena MayKing Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 15, 1919

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

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