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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000665

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marion DorisHussey Sex Female

Date of Birth September 4, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Thomas Hussey MAIDEN NAME of Mother Beatrice Evans

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 Clerk, Dominion Coal Company Place of birth of Father Little Bay, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Beatrice Hussey Address of Applicant 201 South East 12th Street, Pompano Beach, Florida, 33060 Date 17 December 1977

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marion DorisHussey

Born at Glace Bay in the County of Cape Breton

That Marion DorisHussey Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on September 4, 1922

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

I am the natural mother of Marion Doris Hussey

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