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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000317

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth November 21, 1922 Place of Birth OxfordCounty of Cumberland

Name of Father Charles Henry Jackman MAIDEN NAME of Mother Helen Hammond Fiske

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

Residence of Father when child was born Oxford, Cumberland Present address of Father Deceased

Occupation of Father at Birth of child Representative of St. Lawrence Flour Mills Place of birth of Father Harrogate, England

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jean MacLean Hart Address of Applicant 182 Lakeview Avenue, Point-Claire, Province of Quebec Date 1 June 1964

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Oxford in the County of Cumberland

That Jean MacLeanJackman Whose Birth is sought to be registered was

born at Oxford Cumberland County on November 21, 1922

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

The applicants oldest sister is my wife

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