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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000676

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Shirley MargueritePalmer Sex Female

Date of Birth January 28, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Harris Kelly Palmer MAIDEN NAME of Mother Maude Lenora Andrews

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

Residence of Father when child was born 70 South Bentinck St. Sydney Present address of Father deceased

Occupation of Father at Birth of child Canadian National Railway, Ltd. Place of birth of Father Yarmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant Shirley Marguerite MacLean Address of Applicant 27 Harrison Ave., Sydney Date March 22, 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Shirley MargueritePalmer

Born at Sydney in the County of Cape Breton

That Shirley MargueritePalmer Whose Birth is sought to be registered was

born at Sydney Cape Breton County on January 28, 1921

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

That I was advised by my parents as a child that I was born on the 25th day of January, 1921 and throughout my lifetime celebrated my birthday on that date.

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