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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000232

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lucy AnnCapstick Sex Female

Date of Birth November 9, 1922 Place of Birth Wreck CoveCounty of Victoria

Name of Father Edmund Capstick MAIDEN NAME of Mother Elizabeth Zwicker

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

Residence of Father when child was born Wreck Cove, Victoria Present address of Father Capstick, Victoria

Occupation of Father at Birth of child Farmer Place of birth of Father Wreck Cove, Victoria

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edmund Capstick Address of Applicant Date 24 March 1957

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lucy AnnCapstick

Born at Wreck Cove in the County of Victoria

That Lucy AnnCapstick Whose Birth is sought to be registered was

born at Wreck Cove Victoria County on November 9, 1922

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

The said Lucy Ann Capstick is my daughter. Baptism Certificate.

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