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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000344

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Inez ClaireBorden Sex Female

Date of Birth January 21, 1922 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Eva Borden

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 Inez Claire Riley Address of Applicant 259 Herring Cove Road, Spryfield, Halifax Date 20 February 1967

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Inez ClaireBorden

Born at Halifax in the County of Halifax

That Inez ClaireBorden Whose Birth is sought to be registered was

born at Halifax Halifax County on January 21, 1922

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

Baptismal Certificate. Record from Welfare records.

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