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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000711

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Margaret IreneGoulden Sex Female

Date of Birth May 15, 1921 Place of Birth LiverpoolCounty of Queens

Name of Father Everett Joseph Goulden MAIDEN NAME of Mother Nellie Mae White

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

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

Occupation of Father at Birth of child Fisherman Place of birth of Father Gunning Cove

Race Name and present address of Physician in attendance at birth

Signature of Applicant Nellie Mae Goulden Address of Applicant Liverpool Date August 19, 1977

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Margaret IreneGoulden

Born at Liverpool in the County of Queens

That Margaret IreneGoulden Whose Birth is sought to be registered was

born at Liverpool Queens County on May 15, 1921

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

Letter of Aug 18/77 - Minister N.D. Titus School records Census records

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