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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000361

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kathleen LucilleErnest Sex Female

Date of Birth September 24, 1922 Place of Birth Mahone BayCounty of Lunenburg

Name of Father Charles Obed Ernst MAIDEN NAME of Mother Annie Loretta Hyson

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

Residence of Father when child was born Mahone Bay, Lunenburg Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Indian Point, Lunenburg

Race Name and present address of Physician in attendance at birth

Signature of Applicant Kathleen Lucille Ernst Address of Applicant Mahone Bay, Lunenburg Date 4 September 1968

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kathleen LucilleErnest

Born at Mahone Bay in the County of Lunenburg

That Kathleen LucilleErnest Whose Birth is sought to be registered was

born at Mahone Bay Lunenburg County on September 24, 1922

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

Near neighbour when child was born

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