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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000486

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Vivian LouiseFoley Sex Female

Date of Birth November 3, 1921 Place of Birth BridgewaterCounty of Lunenburg

Name of Father Aubrey Charles Foley MAIDEN NAME of Mother Emma Myra Beck

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

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

Occupation of Father at Birth of child Surveyor of Lumber Place of birth of Father Bridgewater

Race Name and present address of Physician in attendance at birth Dr. W.n. Rehfuss

Signature of Applicant Emma Myra Foley Address of Applicant 921 King St. Bridgewater Date February 10, 1972

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Vivian LouiseFoley

Born at Bridgewater in the County of Lunenburg

That Vivian LouiseFoley Whose Birth is sought to be registered was

born at Bridgewater Lunenburg County on November 3, 1921

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

Certificate of Baptism

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