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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100027

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lillian BeatriceKelly Sex Female

Date of Birth June 24, 1922 Place of Birth WatervilleCounty of Kings

Name of Father James Kelly MAIDEN NAME of Mother Lottie Viola Bent

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

Residence of Father when child was born Nova Scotia Present address of Father Deceased

Occupation of Father at Birth of child Mason Place of birth of Father Nova Scotia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Beatrice Gallant Address of Applicant 1033F Jones Road, New Minas, Kings Date 17 September 1985

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lillian BeatriceKelly

Born at Waterville in the County of Kings

That Lillian BeatriceKelly Whose Birth is sought to be registered was

born at Waterville Kings County on June 24, 1922

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

School records

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