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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100016

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Regina MayGordon Sex Female

Date of Birth November 24, 1921 Place of Birth East ChezzetcookCounty of Halifax

Name of Father Archie Gordon MAIDEN NAME of Mother Blanche Grady

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

Residence of Father when child was born East Chezzetcook Present address of Father deceased

Occupation of Father at Birth of child Miner Place of birth of Father State of Maine, USA

Race Name and present address of Physician in attendance at birth

Signature of Applicant Regina May Moore Address of Applicant 44 Bissett Rd. Cole Habour Date June 15, 1983

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Regina MayGordon

Born at East Chezzetcook in the County of Halifax

That Regina MayGordon Whose Birth is sought to be registered was

born at East Chezzetcook Halifax County on November 24, 1921

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

By my baptismal certificate from St. Genevieve's Church, East Chezzetbook, Nova Scotia

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