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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000502

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary MarthaMaillet Sex Female

Date of Birth October 22, 1921 Place of Birth YarmouthCounty of Yarmouth

Name of Father John Maillet MAIDEN NAME of Mother Madeline Muise

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

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

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

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

Signature of Applicant Martha Mary Copeland Address of Applicant 63 Crescent St. Bridgewater Date September 25, 1972

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary MarthaMaillet

Born at Yarmouth in the County of Yarmouth

That Mary MarthaMaillet Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on October 22, 1921

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

Information given to me orally by my mother and Baptismal Certificate

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