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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000118

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rose PriscillaGraves Sex Female

Date of Birth July 5, 1921 Place of Birth YarmouthCounty of Yarmouth

Name of Father   MAIDEN NAME of Mother Marjorie Graves

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 Rose Priscilla Hooper Address of Applicant 137 Orange St. St. John, New Brunswick Date January 6, 1950

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rose PriscillaGraves

Born at Yarmouth in the County of Yarmouth

That Rose PriscillaGraves Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on July 5, 1921

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

Certificate of Birth and Baptism attached.

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