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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000321

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gladys AdalineThompson Sex Female

Date of Birth January 2, 1921 Place of Birth South VictoriaCounty of Cumberland

Name of Father James Ward Thompson MAIDEN NAME of Mother Sarah Freda Weeks

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

Residence of Father when child was born South Victoria Present address of Father Pugwash

Occupation of Father at Birth of child Railway Section man Place of birth of Father Victoria

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

Signature of Applicant Mrs. Ward Thompson Address of Applicant Pugwash Date August 6, 1963

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gladys AdalineThompson

Born at South Victoria in the County of Cumberland

That Gladys AdalineThompson Whose Birth is sought to be registered was

born at South Victoria Cumberland County on January 2, 1921

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

I am the mother of Gladys Adaline Thompson

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