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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000847

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Phyllis LorettaHimmelman Sex Female

Date of Birth October 26, 1921 Place of Birth West LaHaveCounty of Lunenburg

Name of Father William Robert Himmelman MAIDEN NAME of Mother Annie Elizabeth Cross

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

Residence of Father when child was born West LaHave Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Phyllis Loretta Conrad Address of Applicant RR3 New Germany Date August 29, 1979

Relationship of Applicant to child applicant

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Phyllis LorettaHimmelman

Born at West LaHave in the County of Lunenburg

That Phyllis LorettaHimmelman Whose Birth is sought to be registered was

born at West LaHave Lunenburg County on October 26, 1921

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

I, your deponent, am Phyllis Loretta Conrad and prior to my marriage I was Phyllis Loretta Himmelman the person for whom delayed registration of birth is sought. I was always told by my family that I was born on October 26, 1921.

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