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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000212

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anne JacquelineHall Sex Female

Date of Birth August 27, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father Ralph Stall MAIDEN NAME of Mother Ellen MacDonald

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

Residence of Father when child was born 217 Cottage Ave. Dominion Present address of Father 23 Unit St. Dominion

Occupation of Father at Birth of child Coal Miner Place of birth of Father Windsor

Race White Name and present address of Physician in attendance at birth Dr. M.G. Tompkins

Signature of Applicant Mrs. Ralph Hall Address of Applicant 23 Union St. Dominion Date October 13, 1955

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anne JacquelineHall

Born at Glace Bay in the County of Cape Breton

That Anne JacquelineHall Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on August 27, 1921

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

My personal knowledge of this fact and corroborated by the enclosed document taken from records of Immaculate Conception Parish, Bridgeport, Glace Bay, N.S.

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