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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000751

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Nancy ElizabethCaldwell Sex Female

Date of Birth October 22, 1921 Place of Birth WindsorCounty of Hants

Name of Father Frederick Caldwell MAIDEN NAME of Mother Annie Dykens

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

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

Occupation of Father at Birth of child Labourer Place of birth of Father Three Mile Plains

Race Name and present address of Physician in attendance at birth

Signature of Applicant Nancy Elizabeth Caldwell Address of Applicant RR2 Windsor Date May 1978

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Nancy ElizabethCaldwell

Born at Windsor in the County of Hants

That Nancy ElizabethCaldwell Whose Birth is sought to be registered was

born at Windsor Hants County on October 22, 1921

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

No record available except applicant who has been residing in this area her entire life

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