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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000224

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Theresa MarieMelanson Sex Female

Date of Birth September 6, 1922 Place of Birth MarshalltownCounty of Digby

Name of Father   MAIDEN NAME of Mother Gertrude Melanson

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 Theresa M. Melanson Address of Applicant 46 Charles Street, Halifax Date 27 September 1957

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Theresa MarieMelanson

Born at Marshalltown in the County of Digby

That Theresa MarieMelanson Whose Birth is sought to be registered was

born at Marshalltown Digby County on September 6, 1922

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

Certification from Convent of Good Shepherd. National Registration report.

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