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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90500319

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen LouiseCain Sex Female

Date of Birth July 3, 1921 Place of Birth YarmouthCounty of Yarmouth

Name of Father Clyde Linden Cain MAIDEN NAME of Mother Hilda May Giles

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Clyde L. Cain Address of Applicant Yarmouth Date 20 October 1939

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen LouiseCain

Born at Yarmouth in the County of Yarmouth

That Helen LouiseCain Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on July 3, 1921

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

I am her Father and I was present at her birth.

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