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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700507

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Annie CommiliasRobinson Sex Female

Date of Birth October 10, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father Timothy Robinson MAIDEN NAME of Mother Annie Bernard

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

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

Occupation of Father at Birth of child Fisherman Place of birth of Father South Bay

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

Signature of Applicant Timothy Robinson Address of Applicant Glace Bay Date 03 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Annie CommiliasRobinson

Born at Glace Bay in the County of Cape Breton

That Annie CommiliasRobinson Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on October 10, 1919

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

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