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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90500748

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Olive AmandaClarke Sex Female

Date of Birth November 17, 1920 Place of Birth Lower GranvilleCounty of Annapolis

Name of Father James Vernon Clarke MAIDEN NAME of Mother Sarah Caroline Mills

Residence of Father when child was born Lower Granville Present address of Father Lower Granville

Occupation of Father at Birth of child Farmer Place of birth of Father Lower Granville

Race Name and present address of Physician in attendance at birth

Signature of Applicant James Vernon Clarke Address of Applicant Lower Granville Date February 22, 1941

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Olive AmandaClarke

Born at Lower Granville in the County of Annapolis

That Olive AmandaClarke Whose Birth is sought to be registered was

born at Lower Granville Annapolis County on November 17, 1920

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

I am the father of Olive Amanda Clarke, and was at home at the time that she was born, and I do well remember the date of her birth.

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