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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000681

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rita LorettaDavis Sex Female

Date of Birth November 28, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Edward Joseph Davis MAIDEN NAME of Mother Gertrude Ann Hawco

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

Residence of Father when child was born Sydney, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Steel Worker Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant William Leo Davis Address of Applicant 46 Catherine Street, Sydney, Cape Breton Date 11 March 1978

Relationship of Applicant to child Brother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rita LorettaDavis

Born at Sydney in the County of Cape Breton

That Rita LorettaDavis Whose Birth is sought to be registered was

born at Sydney Cape Breton County on November 28, 1922

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

Baptismal certificate (now in possession of Deputy Registrar General)

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