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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000563

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Emily KatherineSmith Sex Female

Date of Birth August 23, 1922 Place of Birth HillsboroCounty of Inverness

Name of Father David Smith MAIDEN NAME of Mother Jennie Cameron

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

Residence of Father when child was born Port Hood, Inverness Present address of Father Deceased

Occupation of Father at Birth of child General Store Manager Place of birth of Father Port Hood, Inverness

Race Name and present address of Physician in attendance at birth

Signature of Applicant Emily Katherine Sweet (Smith) Address of Applicant 37 St. Marys Street, Antigonish Date 26 January 1976

Relationship of Applicant to child One and the same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Emily KatherineSmith

Born at Hillsboro in the County of Inverness

That Emily KatherineSmith Whose Birth is sought to be registered was

born at Hillsboro Inverness County on August 23, 1922

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

Record in family Bible as per certification of Notary Public hereto attached.

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