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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000502

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ruth BerniceCotton Sex Female

Date of Birth February 11, 1922 Place of Birth AtholCounty of Cumberland

Name of Father Samuel Hall Cotton MAIDEN NAME of Mother Barbara Ellen Porter

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

Residence of Father when child was born Athol, Cumberland Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Prince Edward Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ruth B. Falkenham Address of Applicant 395 Gibbon Street, Oshawa, Ontario Date 27 June 1973

Relationship of Applicant to child Applicant is the child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ruth BerniceCotton

Born at Athol in the County of Cumberland

That Ruth BerniceCotton Whose Birth is sought to be registered was

born at Athol Cumberland County on February 11, 1922

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

I am the applicant and I submit herewith Certificate of Baptism showing the date of my birth and the date of baptism. Also submitted are: originals of public school certificate dated June 25, 1930; public school diploma dated June 29, 1938; Marriage certificate dated January 14, 1939 and registration certificate dated August 19, 1940

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