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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000607

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alice LilianIngraham Sex Female

Date of Birth April 25, 1921 Place of Birth Neils HarbourCounty of Victoria

Name of Father John James Ingraham MAIDEN NAME of Mother Ethel Blanche Fricker

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

Residence of Father when child was born Neils Harbour Present address of Father Neils Harbour

Occupation of Father at Birth of child Fisherman Place of birth of Father Neils Harbour

Race Name and present address of Physician in attendance at birth

Signature of Applicant Alice Dowling Address of Applicant Ingonish Date January 1, 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alice LilianIngraham

Born at Neils Harbour in the County of Victoria

That Alice LilianIngraham Whose Birth is sought to be registered was

born at Neils Harbour Victoria County on April 25, 1921

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

Baptism Marriage

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