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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100203

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rita FlorenceMills Sex Female

Date of Birth December 30, 1921 Place of Birth AntigonishCounty of Antigonish

Name of Father Dan  Mills MAIDEN NAME of Mother Sarah MacDonald

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

Residence of Father when child was born Black Avon Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Black Avon

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Rita F. Cameron Address of Applicant Port Hawkesbury Date February 13, 1988

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rita FlorenceMills

Born at Antigonish in the County of Antigonish

That Rita FlorenceMills Whose Birth is sought to be registered was

born at Antigonish Antigonish County on December 30, 1921

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

That is the date I have always celebrated my birthday since my earliest memory. Also my Certificate of Birth and Baptism issued by my Church establishes that I was born at Antigonish on December 30, 1921

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