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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000380

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Elsie FrancesSmith Sex Female

Date of Birth July 9, 1921 Place of Birth Hammonds PlainsCounty of Halifax

Name of Father William Smith MAIDEN NAME of Mother Daisy Thompson

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

Residence of Father when child was born Hammonds Plains Present address of Father Hammonds Plains

Occupation of Father at Birth of child Labourer Place of birth of Father Hammonds Plains

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

Signature of Applicant Elsie Frances Kynock Address of Applicant Hammonds Plains Date April 10, 1968

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Elsie FrancesSmith

Born at Hammonds Plains in the County of Halifax

That Elsie FrancesSmith Whose Birth is sought to be registered was

born at Hammonds Plains Halifax County on July 9, 1921

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

Bible Record School Record Marriage Record The name Francis on Bible record in error correct name Frances

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