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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000306

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lena ViolaMoser Sex Female

Date of Birth May 11, 1922 Place of Birth MooseheadCounty of Halifax

Name of Father Norman Moser MAIDEN NAME of Mother Ruby Moser

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

Residence of Father when child was born Moser River, Halifax Present address of Father Moosehead, Halifax

Occupation of Father at Birth of child Carpenter - Fisherman Place of birth of Father Moosehead, Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ruby Moser Address of Applicant Moosehead, Halifax Date 18 March 1964

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lena ViolaMoser

Born at Moosehead in the County of Halifax

That Lena ViolaMoser Whose Birth is sought to be registered was

born at Moosehead Halifax County on May 11, 1922

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

On leaf of family bible in the home of Norman Moser, Moosehead, Halifax.

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