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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000207

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth August 24, 1922 Place of Birth YarmouthCounty of Yarmouth

Name of Father Roland Earl Nickerson MAIDEN NAME of Mother Alice Rosa Hubbard

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

Residence of Father when child was born Yarmouth Bar, Yarmouth Present address of Father Overton, Yarmouth

Occupation of Father at Birth of child Fisherman Place of birth of Father Lockeport, Shelburne

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Roland E. Nickerson Address of Applicant Overton, Yarmouth Date 30 April 1956

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Yarmouth in the County of Yarmouth

That Helen FloraNickerson Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on August 24, 1922

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

I am the mother and know the above facts to be true. School record. Age in National Registration record.

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