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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100068

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lillian FlorenceSlade Sex Female

Date of Birth September 12, 1921 Place of Birth Birch GroveCounty of Cape Breton

Name of Father Ernest Slade MAIDEN NAME of Mother Margaret 

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

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

Occupation of Father at Birth of child Miner Place of birth of Father Victoria

Race Name and present address of Physician in attendance at birth

Signature of Applicant Florence Cole Address of Applicant Victoria, Newfoundland Date June 13, 1984

Relationship of Applicant to child n/a

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lillian FlorenceSlade

Born at Birch Grove in the County of Cape Breton

That Lillian FlorenceSlade Whose Birth is sought to be registered was

born at Birch Grove Cape Breton County on September 12, 1921

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

I have in my possession Certificate of Baptism to that effect and I personally accept this as my birth date

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