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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000703

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Eva MayDouthwrite Sex Female

Date of Birth January 8, 1922 Place of Birth AmherstCounty of Cumberland

Name of Father Whitfield Douthwrite MAIDEN NAME of Mother Annie may Thompson

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

Residence of Father when child was born Amherst Present address of Father Deceased

Occupation of Father at Birth of child Truck Driver Place of birth of Father Elgin, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant Eva M. Bishop Address of Applicant River Road, Fairvale, New Brunswick Date 16 August 1978

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Eva MayDouthwrite

Born at Amherst in the County of Cumberland

That Eva MayDouthwrite Whose Birth is sought to be registered was

born at Amherst Cumberland County on January 8, 1922

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

per enclosed baptismal certificate

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