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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000388

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lorraine Elizabeth MinaConrad Sex Female

Date of Birth June 2, 1922 Place of Birth DartmouthCounty of Halifax

Name of Father Kenneth Chester Conrod MAIDEN NAME of Mother Stella McCall

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

Residence of Father when child was born 81 Fairbanks Street, Dartmouth Present address of Father 27 Beaver Crescent, Dartmouth

Occupation of Father at Birth of child Chauffeur Place of birth of Father Dartmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lorraine E. M. Clarke (nee: Conrod) Address of Applicant 3 Lorraine Street, Dartmouth Date May 1970

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lorraine Elizabeth MinaConrad

Born at Dartmouth in the County of Halifax

That Lorraine Elizabeth MinaConrad Whose Birth is sought to be registered was

born at Dartmouth Halifax County on June 2, 1922

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

Baptism certificate and marriage record.

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