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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000193

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ethel LouisaFaulkenham Sex Female

Date of Birth May 7, 1921 Place of Birth Whynots SettlementCounty of Lunenburg

Name of Father William Faulkenham MAIDEN NAME of Mother Clara Alberta Veinotte

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

Residence of Father when child was born Whynots Settlement Present address of Father Whynots Settlement

Occupation of Father at Birth of child Farmer Place of birth of Father Summerside now called Dayspring

Race Canadian Name and present address of Physician in attendance at birth F.R. Davis M.D.

Signature of Applicant Clara Alberta Faulkenham Address of Applicant Whynots Settlement Date November 18, 1954

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ethel LouisaFaulkenham

Born at Whynots Settlement in the County of Lunenburg

That Ethel LouisaFaulkenham Whose Birth is sought to be registered was

born at Whynots Settlement Lunenburg County on May 7, 1921

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

That I am the mother of Ethel Laura Faulkenham and I have my memory refreshed by reference to our family Bible (Notorys certificate attached) (Baptism certificate and Bible record)

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