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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000210

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean MargaretCameron Sex Female

Date of Birth September 20, 1922 Place of Birth Wentworth StationCounty of Colchester

Name of Father   MAIDEN NAME of Mother Mary Margaret Cameron

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Matilda Brown Address of Applicant Belmont, Colchester Date 28 July 1956

Relationship of Applicant to child Foster parent

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean MargaretCameron

Born at Wentworth Station in the County of Colchester

That Jean MargaretCameron Whose Birth is sought to be registered was

born at Wentworth Station Colchester County on September 20, 1922

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

Enclosed: certificate of baptism and certificate of school attendance record. The Jean Margaret Cameron mentioned on the adoption order, dated at New Glasgow, Pictou County, December 18th, 1923 is the same person mentioned above.

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