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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000883

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Veronica AgnesShunamon Sex Female

Date of Birth September 21, 1921 Place of Birth BeaverbankCounty of Halifax

Name of Father Jacob Shunamon MAIDEN NAME of Mother Veronica Nugent

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

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

Occupation of Father at Birth of child Fireman Place of birth of Father Beaverbank

Race Name and present address of Physician in attendance at birth

Signature of Applicant Veronica MacLean Address of Applicant 8 Elwood Dr. Dartmouth Date May 2, 1980

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Veronica AgnesShunamon

Born at Beaverbank in the County of Halifax

That Veronica AgnesShunamon Whose Birth is sought to be registered was

born at Beaverbank Halifax County on September 21, 1921

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

Baptismal

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