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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93501864

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Hazel ElsieKilcup Sex Female

Date of Birth May 26, 1906 Place of Birth New MinasCounty of Kings

Name of Father Fred A. Kilcup MAIDEN NAME of Mother Mary L. Gould

Residence of Father when child was born Kentville Present address of Father New Minas

Occupation of Father at Birth of child Engineer Place of birth of Father Liverpool

Race English Name and present address of Physician in attendance at birth Dr. W.S. Woodworth

Signature of Applicant C.H. Kilcup Address of Applicant Kentville Date 5 June 1926

Relationship of Applicant to child brother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Hazel ElsieKilcup

Born at New Minas in the County of Kings

That Hazel ElsieKilcup Whose Birth is sought to be registered was

born at New Minas Kings County on May 26, 1906

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

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