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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000500

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Martha MadelineTolbart Sex Female

Date of Birth June 3, 1922 Place of Birth KentvilleCounty of Kings

Name of Father James Albert Tolbart MAIDEN NAME of Mother Hally Taylor

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

Residence of Father when child was born Bridgetown, Annapolis Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Annapolis Royal, Annapolis

Race Name and present address of Physician in attendance at birth

Signature of Applicant Martha M. Stevens Address of Applicant RR #3, Oromocto, New Brunswick Date 2 November 1973

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Martha MadelineTolbart

Born at Kentville in the County of Kings

That Martha MadelineTolbart Whose Birth is sought to be registered was

born at Kentville Kings County on June 3, 1922

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

I am the person so named in the record as shown in the Family Bible - which record forms basis of attached Affidavit. My married name is Martha Madeline Stevens.

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