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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93602432

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harriett JeaneKeith Sex Female

Date of Birth September 2, 1906 Place of Birth Glace BayCounty of Cape Breton

Name of Father John Malcolm Keith MAIDEN NAME of Mother Tina Grant Stewart

Residence of Father when child was born Glace Bay Present address of Father Bible Hill

Occupation of Father at Birth of child Carpenter Place of birth of Father Montague, Prince Edward Island

Race Scottish Name and present address of Physician in attendance at birth

Signature of Applicant Harriett Jeane Keith Address of Applicant Bible Hill Date 26 August 1926

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harriett JeaneKeith

Born at Glace Bay in the County of Cape Breton

That Harriett JeaneKeith Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on September 2, 1906

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

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