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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000012

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of JackBenson Sex Male

Date of Birth August 28, 1921 Place of Birth PictouCounty of Pictou

Name of Father   MAIDEN NAME of Mother Isabel Benson

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

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

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

Signature of Applicant Mrs. Jane MacPherson Address of Applicant 3 Livingstone Place Date July 31, 1946

Relationship of Applicant to child Foster Mother

AFFIDAVIT

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

Born at Pictou in the County of Pictou

That JackBenson Whose Birth is sought to be registered was

born at Pictou Pictou County on August 28, 1921

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

I have obtained the accompanying letter containing the above stated facts from Miss Kerr the Superintendent of the Infants home, the Institution from which my first husband Mr. John W. Wilkie and myself took this child when he was a year and a half old.

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