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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000024

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anita MargaretCampbell Sex Female

Date of Birth June 23, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Alexander D. Campbell MAIDEN NAME of Mother Katherine Campbell

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

Residence of Father when child was born Glace Bay, Cape Breton Present address of Father Glace Bay, Cape Breton

Occupation of Father at Birth of child Miner Place of birth of Father Glencoe, Inverness

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Katherine Campbell Address of Applicant 21 Currie Street, Glace Bay, Cape Breton Date 21 July 1947

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anita MargaretCampbell

Born at Glace Bay in the County of Cape Breton

That Anita MargaretCampbell Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on June 23, 1922

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

I am the mother of the said Anita Margaret Campbell

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