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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000195

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen VivianYoung Sex Female

Date of Birth May 6, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father John Young MAIDEN NAME of Mother Catherine Rogers

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

Residence of Father when child was born 6 Hillside Avenue, Glace Bay, Cape Breton Present address of Father 6 Hillside Avenue, Glace Bay, Cape Breton

Occupation of Father at Birth of child Miner Place of birth of Father Sydney Mines, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Helen Vivian Beck Address of Applicant 288 Main Street, Bridgeport, Glace Bay Date 12 August 1955

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen VivianYoung

Born at Glace Bay in the County of Cape Breton

That Helen VivianYoung Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 6, 1922

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

I am her mother. Baptismal certificate attached.

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