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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000572

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Elizabeth CatherineHasey Sex Female

Date of Birth April 6, 1922 Place of Birth AntigonishCounty of Antigonish

Name of Father Daniel Hasey MAIDEN NAME of Mother Mary MacKay

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

Residence of Father when child was born Antigonish Present address of Father Died September 1961 or 1962

Occupation of Father at Birth of child Farmer Place of birth of Father Antigonish

Race Name and present address of Physician in attendance at birth

Signature of Applicant Elizabeth Scolire Address of Applicant Date 16 March 1976

Relationship of Applicant to child Applicant is child in question

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Elizabeth CatherineHasey

Born at Antigonish in the County of Antigonish

That Elizabeth CatherineHasey Whose Birth is sought to be registered was

born at Antigonish Antigonish County on April 6, 1922

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

1. Baptismal Certificate and 2. Marriage License

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