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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000094

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Edith EvelynSmith Sex Female

Date of Birth May 27, 1922 Place of Birth SandfordCounty of Yarmouth

Name of Father Richard Thomas Smith MAIDEN NAME of Mother Geneva Evelyn Crosby

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

Residence of Father when child was born Sandford, Yarmouth Present address of Father Sandford, Yarmouth

Occupation of Father at Birth of child Meat Cutter Place of birth of Father Sandford, Yarmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edith Crosby Address of Applicant Hebron, Yarmouth Date 11 August 1949

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Edith EvelynSmith

Born at Sandford in the County of Yarmouth

That Edith EvelynSmith Whose Birth is sought to be registered was

born at Sandford Yarmouth County on May 27, 1922

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

My knowledge of my birth is taken from the record of the physician in attendance at birth and sworn to the physician Dr. W. C. Harris and from information given by my parents.

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