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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000428

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 28, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Clifford Driscoll MAIDEN NAME of Mother Annie Kane

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

Residence of Father when child was born Halifax Present address of Father Elmsdale

Occupation of Father at Birth of child Fireman C.N.R. Place of birth of Father Halifax

Race Irish Name and present address of Physician in attendance at birth Dr. R. Hawkins

Signature of Applicant Jean L. Vaughan Address of Applicant 13 Sunset Dr. Dartmouth Date April 2, 1970

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Halifax in the County of Halifax

That Jean LaurieDriscoll Whose Birth is sought to be registered was

born at Halifax Halifax County on April 28, 1921

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

Certificate of Baptism School record

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