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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000898

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary ElizabethWhiteley Sex Female

Date of Birth July 1, 1922 Place of Birth DartmouthCounty of Halifax

Name of Father James Whiteley MAIDEN NAME of Mother Agnes Pettipas

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

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Leetham Address of Applicant RR #1, Porters Lake, Halifax Date 21 June 1982

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary ElizabethWhiteley

Born at Dartmouth in the County of Halifax

That Mary ElizabethWhiteley Whose Birth is sought to be registered was

born at Dartmouth Halifax County on July 1, 1922

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

Baptismal certificate Marriage extract

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