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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000489

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Iris MayRobart Sex Female

Date of Birth August 28, 1921 Place of Birth HarmonyCounty of Kings

Name of Father Whitfield H. Robart MAIDEN NAME of Mother Livian May Hiltz

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

Residence of Father when child was born Harmony Present address of Father Nicholsville

Occupation of Father at Birth of child Farmer Place of birth of Father Lake George

Race English Name and present address of Physician in attendance at birth deceased

Signature of Applicant Livian M. Robart Address of Applicant Nicholsville Date August 26, 1950

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Iris MayRobart

Born at Harmony in the County of Kings

That Iris MayRobart Whose Birth is sought to be registered was

born at Harmony Kings County on August 28, 1921

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

I am her mother.

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