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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000161

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Phyllis GloriaAwalt Sex Female

Date of Birth April 27, 1921 Place of Birth North BrookfieldCounty of Queens

Name of Father David W. Awalt MAIDEN NAME of Mother Edith E. Trethewey

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

Residence of Father when child was born North Brookfield Present address of Father Bridgewater

Occupation of Father at Birth of child Merchant Place of birth of Father Baker Settlement

Race German Name and present address of Physician in attendance at birth Dr. J.B. March

Signature of Applicant David Awalt Address of Applicant Bridgewater Date July 2, 1952

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Phyllis GloriaAwalt

Born at North Brookfield in the County of Queens

That Phyllis GloriaAwalt Whose Birth is sought to be registered was

born at North Brookfield Queens County on April 27, 1921

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

I remember when Phyllis Gloria Awalt was born as I was married January 10, 1921 and she was born April 27, 1921 3 months later - I remember the exact date as my husbands birthday is the day after - (Census report and school records)

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