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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

60600430

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rosalee JeanMcAuley Sex Female

Date of Birth January 22, 1922 Place of Birth Clarks HarbourCounty of Shelburne

Name of Father Franklin A. McAuley MAIDEN NAME of Mother Verna E. Nickerson

Residence of Father when child was born Clarks Harbour Present address of Father East Boston, Massachusetts, USA

Occupation of Father at Birth of child Movie Operator Place of birth of Father Quincy, Massachusetts, USA

Race English Name and present address of Physician in attendance at birth Dr. Brown

Signature of Applicant Franklin A. McAuley Address of Applicant East Boston, Massachusetts, USA Date 29 January 1930

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rosalee JeanMcAuley

Born at Clarks Harbour in the County of Shelburne

That Rosalee JeanMcAuley Whose Birth is sought to be registered was

born at Clarks Harbour Shelburne County on January 22, 1922

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

That I am the Father of the child.

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