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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000848

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy OlgaNichols Sex Female

Date of Birth November 2, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Charles Nicols MAIDEN NAME of Mother Alice Laffin

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

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

Occupation of Father at Birth of child Rivetter Place of birth of Father Russia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dorothy Tarr Address of Applicant 34 Woodcrst Ave. Spryfield Date September 11, 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy OlgaNichols

Born at Halifax in the County of Halifax

That Dorothy OlgaNichols Whose Birth is sought to be registered was

born at Halifax Halifax County on November 2, 1921

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

Baptismal

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