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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000753

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Leona CamillaLockman Sex Female

Date of Birth January 17, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father John J. Lockman MAIDEN NAME of Mother Veronica MacInnis

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 Miner Place of birth of Father Glace Bay, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Leona Camilla Graham, nee: Lockman Address of Applicant 263 Main Street, Glace Bay, Cape Breton Date 4 May 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Leona CamillaLockman

Born at Glace Bay in the County of Cape Breton

That Leona CamillaLockman Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on January 17, 1922

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

Certification from records of Immaculate Conception Parish Certification from records of St. Josephs Hospital, Glace Bay Personal knowledge passed on from my parents

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