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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100149

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Agnes EvelynNearing Sex

Date of Birth May 21, 1922 Place of Birth New WaterfordCounty of Cape Breton

Name of Father William Nearing MAIDEN NAME of Mother Agnes McNeil

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

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

Occupation of Father at Birth of child Place of birth of Father Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Agnes Evelyn Hicks Address of Applicant 95 Vista Blvd., Mississauga, Ontario, L5M 1V8 Date 12 December 2001

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Agnes EvelynNearing

Born at New Waterford in the County of Cape Breton

That Agnes EvelynNearing Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on May 21, 1922

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

Certificate of birth & baptism

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