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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000421

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth October 12, 1922 Place of Birth LaHaveCounty of Lunenburg

Name of Father Marshall Stephen Corkum MAIDEN NAME of Mother Edith Beatrice Zwicker

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

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

Occupation of Father at Birth of child Chauffeur Place of birth of Father LaHave, Lunenburg

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Garnet Hiltz Address of Applicant RR #2, Lower Sackville, Halifax Date 22 July 1971

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary Kathleen MayCorkum

Born at LaHave in the County of Lunenburg

That Mary Kathleen MayCorkum Whose Birth is sought to be registered was

born at LaHave Lunenburg County on October 12, 1922

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

Baptismal certificate

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