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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000654

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Nellie IrisZinck Sex Female

Date of Birth February 18, 1921 Place of Birth WaldenCounty of Lunenburg

Name of Father Percy Cecil St. Clair Zinck MAIDEN NAME of Mother Minnie Alberta Joudrey

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

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

Occupation of Father at Birth of child Labourer Place of birth of Father Walden

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Nellie Kaizer Address of Applicant Walden Date October 8, 1976

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Nellie IrisZinck

Born at Walden in the County of Lunenburg

That Nellie IrisZinck Whose Birth is sought to be registered was

born at Walden Lunenburg County on February 18, 1921

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

I am her sister we went to school together and we both lived at Walden Lunenburg County N.S. all our lives.

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