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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000501

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mildred JeanRowe Sex Female

Date of Birth December 21, 1921 Place of Birth MartiniqueCounty of Richmond

Name of Father Samuel Moses Rowe MAIDEN NAME of Mother Edna Levina LeLacheur

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

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

Occupation of Father at Birth of child Iron worker Place of birth of Father Heart Content, Newfoundland

Race English Name and present address of Physician in attendance at birth Dr. B.A. LeBlanc

Signature of Applicant Edna Levina Rowe Address of Applicant 63 Kimberly Dr. Sydney Date September 5, 1972

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mildred JeanRowe

Born at Martinique in the County of Richmond

That Mildred JeanRowe Whose Birth is sought to be registered was

born at Martinique Richmond County on December 21, 1921

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

Being my daughter I have knowledge of her birth, the day and the year my daughter was born and the place and circumstances I do well remember and morever the Certificate of her Baptism is a true and legal document of her birth.

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