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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000247

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anna EttaHayne Sex Female

Date of Birth March 8, 1921 Place of Birth StellartonCounty of Pictou

Name of Father Harold Henry Hayne MAIDEN NAME of Mother Georgina May Hollie

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

Residence of Father when child was born Stellarton Present address of Father deceased

Occupation of Father at Birth of child Miner Place of birth of Father Country Harbour

Race English Name and present address of Physician in attendance at birth George Whitman

Signature of Applicant Georgina May Hayne Address of Applicant 39 Westville Rd. New Glasgow Date September 23, 1957

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anna EttaHayne

Born at Stellarton in the County of Pictou

That Anna EttaHayne Whose Birth is sought to be registered was

born at Stellarton Pictou County on March 8, 1921

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

I am her mother Family Record School Record

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