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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000405

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean ChristineFraser Sex Female

Date of Birth July 25, 1921 Place of Birth MeadowvilleCounty of Pictou

Name of Father George Edward Fraser MAIDEN NAME of Mother Isabelle Jane Baillie

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

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

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

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

Signature of Applicant Jean C. Campbell Address of Applicant RR 1 Thorburn Date April 6, 1967

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean ChristineFraser

Born at Meadowville in the County of Pictou

That Jean ChristineFraser Whose Birth is sought to be registered was

born at Meadowville Pictou County on July 25, 1921

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

That I am the Mother of the said Jean Christine Fraser

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