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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000524

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Muriel MarieJohnson Sex Female

Date of Birth August 14, 1922 Place of Birth WatervilleCounty of Kings

Name of Father James Philip Johnson MAIDEN NAME of Mother Bertha Mae Swimmher

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

Residence of Father when child was born Waterville, Kings Present address of Father Dead

Occupation of Father at Birth of child Labourer Place of birth of Father Unknown (possibly Kentville)

Race Name and present address of Physician in attendance at birth

Signature of Applicant Muriel Marie Johnson Address of Applicant RR #3, Highbury, Kings Date 12 August 1974

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Muriel MarieJohnson

Born at Waterville in the County of Kings

That Muriel MarieJohnson Whose Birth is sought to be registered was

born at Waterville Kings County on August 14, 1922

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

Muriel Marie Johnson was my pupil in Highbury School, Kings in the year 1932-33 and I have known her since birth.

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