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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100119

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lydia FrancesKeats Sex Female

Date of Birth November 4, 1922 Place of Birth DominionCounty of Cape Breton

Name of Father Samuel Keats MAIDEN NAME of Mother Frances Hicks

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

Residence of Father when child was born Dominion, Cape Breton Present address of Father

Occupation of Father at Birth of child Place of birth of Father St. John's, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Frances Gallant Address of Applicant 124 Mitchell Avenue, Dominion, Cape Breton Date 7 February 1990

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lydia FrancesKeats

Born at Dominion in the County of Cape Breton

That Lydia FrancesKeats Whose Birth is sought to be registered was

born at Dominion Cape Breton County on November 4, 1922

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

Birth and baptismal certificate from All Saints Rectory, New Waterford, Cape Breton and certification from school admittance records from the Town of Dominion. Also personal knowledge passed on to me from my parents, both deceased.

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