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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90500314

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary ViethBrown Sex Female

Date of Birth July 27, 1921 Place of Birth DartmouthCounty of Halifax

Name of Father William N. Brown MAIDEN NAME of Mother Janice Letson Vieth

Residence of Father when child was born Dartmouth Present address of Father Dartmouth

Occupation of Father at Birth of child Clerk Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant W.N. Brown Address of Applicant 13 McKay St. Dartmouth Date 31 August 1939

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary ViethBrown

Born at Dartmouth in the County of Halifax

That Mary ViethBrown Whose Birth is sought to be registered was

born at Dartmouth Halifax County on July 27, 1921

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

father and was at home and know that the date of birth of Mary Vieth Brown is as stated as above.

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