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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000030

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth March 21, 1921 Place of Birth Steam Mill VillageCounty of Kings

Name of Father Amos J. Veinot MAIDEN NAME of Mother Laura DeEll

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Steam Mill Village Present address of Father Steam Mill Village

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

Race Canadian Name and present address of Physician in attendance at birth Dr. Bishop

Signature of Applicant Amos J. Veinot Address of Applicant West Halls Harbour Date September 25, 1946

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at Steam Mill Village in the County of Kings

That Helen RebeccaVeinot Whose Birth is sought to be registered was

born at Steam Mill Village Kings County on March 21, 1921

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

I am her father

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