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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600284

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alice MargaretFord Sex Female

Date of Birth November 17, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Sydney Lucan MAIDEN NAME of Mother Ethel May Ford

Residence of Father when child was born 165 Creighton Street, Halifax, NS Present address of Father Deceased (Halifax0

Occupation of Father at Birth of child Porter Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ethel Brown Address of Applicant 271 Brunswick Street, Halifax, NS Date 27 April 1934

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alice MargaretFord

Born at Halifax in the County of Halifax

That Alice MargaretFord Whose Birth is sought to be registered was

born at Halifax Halifax County on November 17, 1921

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

I am her mother

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