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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000201

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bernice MarieMcLeod Sex Female

Date of Birth July 28, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Frank McLeod MAIDEN NAME of Mother Alice Borden

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

Residence of Father when child was born 197 Brunswick St. Halifax Present address of Father Fairview

Occupation of Father at Birth of child Meat Merchant Place of birth of Father Truro

Race Scottish Name and present address of Physician in attendance at birth Dr. P.A. MacDonald

Signature of Applicant Alice McLeod Address of Applicant 51 Evans Ave. Fairview Date May 11, 1955

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bernice MarieMcLeod

Born at Halifax in the County of Halifax

That Bernice MarieMcLeod Whose Birth is sought to be registered was

born at Halifax Halifax County on July 28, 1921

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

Baptismal Certificate Attached School Records

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