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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000531

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marjorie HelenFeltmate Sex Female

Date of Birth October 26, 1921 Place of Birth CansoCounty of Guysborough

Name of Father John Feltmate MAIDEN NAME of Mother Kate Rossony

Were the Parents married at the time of the Birth? No

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

Occupation of Father at Birth of child Labourer Place of birth of Father Fortune Bay, Newfoundland

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

Signature of Applicant A.G. Clarke Address of Applicant 6870 Chebucto Rd. Halifax Date November 16, 1973

Relationship of Applicant to child Son-in-law

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marjorie HelenFeltmate

Born at Canso in the County of Guysborough

That Marjorie HelenFeltmate Whose Birth is sought to be registered was

born at Canso Guysborough County on October 26, 1921

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

Baptism Certificate School Record Baptism Certificate in error of first given name of child.

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