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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100177

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Emma RosettaReynolds Sex Female

Date of Birth August 5, 1921 Place of Birth Port HawkesburyCounty of Inverness

Name of Father Edward Elija Reynolds MAIDEN NAME of Mother Mary MacRae

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

Residence of Father when child was born Port Hawkesbury Present address of Father deceased

Occupation of Father at Birth of child Bricklayer Place of birth of Father Steep Creek

Race Name and present address of Physician in attendance at birth

Signature of Applicant Emma Rosetta Reynolds Address of Applicant RR1 Port Hastings Date April 29, 1986

Relationship of Applicant to child n/a

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Emma RosettaReynolds

Born at Port Hawkesbury in the County of Inverness

That Emma RosettaReynolds Whose Birth is sought to be registered was

born at Port Hawkesbury Inverness County on August 5, 1921

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

My parents informed me as I was advised that I was born on Aug 5 1921 and my school record and church records confirm this date.

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