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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93602209

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of MarcellaStewart Sex Female

Date of Birth September 13, 1906 Place of Birth New Harris ForksCounty of Victoria

Name of Father Dan Stewart MAIDEN NAME of Mother Jessie Carmichael

Residence of Father when child was born New Harris Forks Present address of Father New Harris Forks

Occupation of Father at Birth of child Farmer Place of birth of Father New Harris Forks

Race Scottish Name and present address of Physician in attendance at birth

Signature of Applicant Jessie Stewart Address of Applicant New Harris Forks Date 6 July 1926

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of MarcellaStewart

Born at New Harris Forks in the County of Victoria

That MarcellaStewart Whose Birth is sought to be registered was

born at New Harris Forks Victoria County on September 13, 1906

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

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