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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000923

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Doris ElizabethHenneberry Sex Female

Date of Birth January 16, 1922 Place of Birth Eastern PassageCounty of Halifax

Name of Father Clarence Henneberry MAIDEN NAME of Mother Hilda Henneberry

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

Residence of Father when child was born Devils Island, Halifax Present address of Father Eastern Passage, Halifax

Occupation of Father at Birth of child Fisherman Place of birth of Father Devils Island, Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Doris E. Naugle Address of Applicant 1602 Shore Road, Eastern Passage, Halifax Date 18 January 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Doris ElizabethHenneberry

Born at Eastern Passage in the County of Halifax

That Doris ElizabethHenneberry Whose Birth is sought to be registered was

born at Eastern Passage Halifax County on January 16, 1922

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

1. Baptismal 2. Marriage Extract

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