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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000695

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Evelyn Muriel MaxineMosher Sex Female

Date of Birth September 4, 1922 Place of Birth WoodsideCounty of Halifax

Name of Father Wilbert Henry Mosher MAIDEN NAME of Mother Henrietta Gould Drake

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

Residence of Father when child was born Woodside, Halifax Present address of Father Deceased

Occupation of Father at Birth of child Bookkeeper Place of birth of Father Dartmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edna M. Hodgson Address of Applicant Date 7 July 1978

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Evelyn Muriel MaxineMosher

Born at Woodside in the County of Halifax

That Evelyn Muriel MaxineMosher Whose Birth is sought to be registered was

born at Woodside Halifax County on September 4, 1922

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

Baptismal certificate

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