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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000446

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Shirley CarminaWilson Sex Female

Date of Birth May 25, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Daniel Allen Wilson MAIDEN NAME of Mother Dorothy Mabel Veno

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

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

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

Race English Name and present address of Physician in attendance at birth Dr. Corston

Signature of Applicant Mrs. J.W. Bennett Address of Applicant 6141 Allen St. Halifax Date November 27, 1970

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Shirley CarminaWilson

Born at Halifax in the County of Halifax

That Shirley CarminaWilson Whose Birth is sought to be registered was

born at Halifax Halifax County on May 25, 1921

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

Baptism Certificate

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