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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000561

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary JaneDuffett Sex Female

Date of Birth May 11, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Albert Duffett MAIDEN NAME of Mother Mary Ann Kelloway

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 Coal Miner Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Jane Duffett (St. Onge) Address of Applicant 2080 Vermont, Sherbrooke, Quebec Date 6 October 1975

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary JaneDuffett

Born at Glace Bay in the County of Cape Breton

That Mary JaneDuffett Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 11, 1922

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

Certificate of Baptism and family history (record)

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