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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000093

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Daisy RosellaBundy Sex Female

Date of Birth July 25, 1921 Place of Birth Cherry BrookCounty of Halifax

Name of Father William Henry Bundy MAIDEN NAME of Mother Myrtle Viola Bundy

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

Residence of Father when child was born Cherry Brook Present address of Father Cherry Brook

Occupation of Father at Birth of child Labourer Place of birth of Father Cherry Brook

Race Colored Name and present address of Physician in attendance at birth Johannah Bundy midwife

Signature of Applicant Daisy Rosella Bundy Address of Applicant Montreal Date July 20, 1948

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Daisy RosellaBundy

Born at Cherry Brook in the County of Halifax

That Daisy RosellaBundy Whose Birth is sought to be registered was

born at Cherry Brook Halifax County on July 25, 1921

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

I am the Mother of Daisy Bundy and that is why I know that Daisy Rosella Bundy was born on July 25, 1921 as it was found recorded in the family Bible that Daisy R. Bundy was born the 25 of July 1921

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