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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000209

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alice MargaretFord Sex Female

Date of Birth November 17, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Ethel May Ford

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Halifax Present address of Father

Occupation of Father at Birth of child Porter on Railway Place of birth of Father Halifax

Race Negro Name and present address of Physician in attendance at birth Dr. Buckley

Signature of Applicant Ethel May Beals Address of Applicant 195 Creighton St. Halifax Date May 28, 1955

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alice MargaretFord

Born at Halifax in the County of Halifax

That Alice MargaretFord Whose Birth is sought to be registered was

born at Halifax Halifax County on November 17, 1921

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

Board of School Commission's record Baptism Certificate issued at time of baptism

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