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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000643

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth October 4, 1921 Place of Birth The FortiesCounty of Lunenburg

Name of Father Nathan Hiltz MAIDEN NAME of Mother Aggie Bezanson

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

Residence of Father when child was born The Forties Present address of Father

Occupation of Father at Birth of child Farmer Place of birth of Father The Forties

Race Name and present address of Physician in attendance at birth

Signature of Applicant Vere Brydon Address of Applicant Cambridge Station Date July 15, 1976

Relationship of Applicant to child Husbnad

AFFIDAVIT

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

Born at The Forties in the County of Lunenburg

That Alice ValeriaHiltz Whose Birth is sought to be registered was

born at The Forties Lunenburg County on October 4, 1921

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

Baptismal Certificate

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