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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000780

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary ViolaCarver Sex Female

Date of Birth August 14, 1921 Place of Birth WaldenCounty of Lunenburg

Name of Father Stephen Carver MAIDEN NAME of Mother Matilda L. Nauss

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 Farmer Place of birth of Father Walden

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Blanche Dorey Address of Applicant Walden Date December 5, 1978

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary ViolaCarver

Born at Walden in the County of Lunenburg

That Mary ViolaCarver Whose Birth is sought to be registered was

born at Walden Lunenburg County on August 14, 1921

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

Sister Certificate of Baptism (Aug 14, 1921)

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