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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000477

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of MaryWilcox Sex Female

Date of Birth December 29, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father John Wilcox MAIDEN NAME of Mother  Jefferson

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 Port Morien, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant John Earl Address of Applicant 92 School Street Date May 1973

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of MaryWilcox

Born at Glace Bay in the County of Cape Breton

That MaryWilcox Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 29, 1922

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

Attached Hospital birth certificate

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