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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000594

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Eileen FlorenceBenjamin Sex Female

Date of Birth June 20, 1921 Place of Birth AmherstCounty of Cumberland

Name of Father Edward Nelson Benjamin MAIDEN NAME of Mother Florence Jeanetta Reynolds

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

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

Occupation of Father at Birth of child Machinist Place of birth of Father Kingsport

Race Name and present address of Physician in attendance at birth

Signature of Applicant Elieen Florence Benjamin Address of Applicant 2 Chamberlain St. Amherst Date 11 September 1975

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Eileen FlorenceBenjamin

Born at Amherst in the County of Cumberland

That Eileen FlorenceBenjamin Whose Birth is sought to be registered was

born at Amherst Cumberland County on June 20, 1921

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

The doctor at the birth of Mrs. MacKenzie was the late Doctor Boudreau, he attended at date of birth of Mrs. MacKenzie at the home (not in Hospital) Mrs. Burgess the midwife had asked me to get lots of hot water before the Doctor arrived

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