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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000794

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth June 14, 1921 Place of Birth AntigonishCounty of Antigonish

Name of Father Allan D. Cameron MAIDEN NAME of Mother Catherine A. MacLean

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

Residence of Father when child was born Antigonish Present address of Father Antigonish

Occupation of Father at Birth of child Teacher Place of birth of Father Fairmount

Race Name and present address of Physician in attendance at birth

Signature of Applicant John J. Tarvier Address of Applicant 47 Forest St. Yarmouth Date January 1979

Relationship of Applicant to child Husband

AFFIDAVIT

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

Born at Antigonish in the County of Antigonish

That Mary ZitaCameron Whose Birth is sought to be registered was

born at Antigonish Antigonish County on June 14, 1921

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

Attached Baptismal Certificate

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