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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000242

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Evelyn MaryRoberts Sex Female

Date of Birth September 12, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Gladys Roberts

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

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Scottish Name and present address of Physician in attendance at birth

Signature of Applicant Edith M. Tikkala Address of Applicant Ottawa Date July 18, 1957

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Evelyn MaryRoberts

Born at Halifax in the County of Halifax

That Evelyn MaryRoberts Whose Birth is sought to be registered was

born at Halifax Halifax County on September 12, 1921

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

1 I am her sister and information form a declaration of our mother 2 School record which gives _ Fathers surname Legge 3 Childrens Aid Society Records

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