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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000347

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Fern ElizabethWalker Sex Female

Date of Birth May 17, 1922 Place of Birth Caribou RiverCounty of Pictou

Name of Father Robert Hugh Walker MAIDEN NAME of Mother Margaret Jane Baird

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

Residence of Father when child was born Caribou River, Pictou Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Baie Verte, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant Fern Elizabeth Sellers Address of Applicant Box 364, Pictou Date 13 April 1967

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Fern ElizabethWalker

Born at Caribou River in the County of Pictou

That Fern ElizabethWalker Whose Birth is sought to be registered was

born at Caribou River Pictou County on May 17, 1922

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

Family bible record and school record.

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