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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100172

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Hattie OliviaPilgrim Sex Female

Date of Birth March 26, 1921 Place of Birth DartmouthCounty of Halifax

Name of Father George Pilgrim MAIDEN NAME of Mother Louise Allen

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

Residence of Father when child was born Pleasant St. Dartmouth Present address of Father deceased

Occupation of Father at Birth of child Seaman Place of birth of Father West Indies

Race Name and present address of Physician in attendance at birth

Signature of Applicant Carlotta Weymouth Address of Applicant 4 Tanting Crescent Dartmouth Date June 2, 1986

Relationship of Applicant to child Daughter

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Hattie OliviaPilgrim

Born at Dartmouth in the County of Halifax

That Hattie OliviaPilgrim Whose Birth is sought to be registered was

born at Dartmouth Halifax County on March 26, 1921

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

1) Baptism 2) Census Report 3) Marriage Extract

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