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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000439

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kathleen SarahThompson Sex Female

Date of Birth March 19, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Fred Thompson MAIDEN NAME of Mother Nellie Wamboldt

Were the Parents married at the time of the Birth? No

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

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

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

Signature of Applicant Kathleen Sarah Thompson Address of Applicant 42 Westhampton Dr. Weston, Ontario Date October 28, 1967

Relationship of Applicant to child I am applying for myself

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kathleen SarahThompson

Born at Halifax in the County of Halifax

That Kathleen SarahThompson Whose Birth is sought to be registered was

born at Halifax Halifax County on March 19, 1921

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

I am one and the same person as Kathleen Sarah Thompson I know of my birth date by hearing my parents speak of this as being my birth date and by my baptismal certificate.

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