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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000437

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen AnitaColeman Sex Female

Date of Birth August 22, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father William Coleman MAIDEN NAME of Mother Mary Lucy Jesse

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

Residence of Father when child was born Glace Bay, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Miner Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Coleman Address of Applicant Glace Bay, Cape Breton Date 13 January 1972

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen AnitaColeman

Born at Glace Bay in the County of Cape Breton

That Helen AnitaColeman Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on August 22, 1922

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

I am her mother and well remember the birth of my daughter

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