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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000575

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Georgina TheresaLays Sex Female

Date of Birth April 22, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father George J. Lays MAIDEN NAME of Mother Theresa Lamont

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 Electrician Place of birth of Father New Castle, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Georgina McDonald Address of Applicant 578 Howe Street, Glace Bay, Cape Breton Date 29 March 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Georgina TheresaLays

Born at Glace Bay in the County of Cape Breton

That Georgina TheresaLays Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on April 22, 1922

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

Certificate of Baptism

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