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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000504

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 2, 1922 Place of Birth GuysboroughCounty of Guysborough

Name of Father Robie Page Burden MAIDEN NAME of Mother Louise Maude Clyke

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

Residence of Father when child was born Guysborough Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Guysborough

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Marion Mansfield Address of Applicant Box 75, Guysborough Date 15 February 1974

Relationship of Applicant to child Application is for self

AFFIDAVIT

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

Born at Guysborough in the County of Guysborough

That MarionBorden Whose Birth is sought to be registered was

born at Guysborough Guysborough County on December 2, 1922

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

Baptism Certificate being held as Class A evidence by Registrar General - see letter from Deputy Registrar General, dated February 7, 1974.

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