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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000476

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Pauline FrancesAnderson Sex Female

Date of Birth January 2, 1922 Place of Birth MelansonCounty of Kings

Name of Father Joseph Secomb Anderson MAIDEN NAME of Mother Laura Minnie Smith

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

Residence of Father when child was born Melanson, Kings Present address of Father Melanson, Kings

Occupation of Father at Birth of child Farmer Place of birth of Father Melanson, Kings

Race Name and present address of Physician in attendance at birth

Signature of Applicant Laura Minnie Anderson Address of Applicant Melanson, Kings Date 7 February 1922

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Pauline FrancesAnderson

Born at Melanson in the County of Kings

That Pauline FrancesAnderson Whose Birth is sought to be registered was

born at Melanson Kings County on January 2, 1922

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

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