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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000547

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Phyllis MargaretAtwell Sex Female

Date of Birth January 21, 1921 Place of Birth HortonvilleCounty of Kings

Name of Father Breton William  Atwell MAIDEN NAME of Mother Alice Elizabeth Britton

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

Residence of Father when child was born Hortonville Present address of Father Oxford

Occupation of Father at Birth of child Lumbering Place of birth of Father Grand Pre

Race Caucasian Name and present address of Physician in attendance at birth Dr. Elliot

Signature of Applicant Phyllis Margaret Gourlay Address of Applicant 4 Vesper Court, Scarborough, Ontario Date September 25, 1972

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Phyllis MargaretAtwell

Born at Hortonville in the County of Kings

That Phyllis MargaretAtwell Whose Birth is sought to be registered was

born at Hortonville Kings County on January 21, 1921

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

Father

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