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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93400945

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Doris BerneiceAnderssen Sex Female

Date of Birth February 1, 1906 Place of Birth Moser RiverCounty of Halifax

Name of Father Carl Hanger Anderssen MAIDEN NAME of Mother Annie Rebecca Lingley

Residence of Father when child was born Moser River Present address of Father Sheet Harbour

Occupation of Father at Birth of child Lumber Merchant Place of birth of Father Moss, Norway

Race Norwegian Name and present address of Physician in attendance at birth Edward Winslow Dunlop

Signature of Applicant Annie Rebecca Lingley Address of Applicant Sheet Harbour Date 7 January 1926

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Doris BerneiceAnderssen

Born at Moser River in the County of Halifax

That Doris BerneiceAnderssen Whose Birth is sought to be registered was

born at Moser River Halifax County on February 1, 1906

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

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