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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600607

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gertrude JaneFeener Sex Female

Date of Birth June 20, 1921 Place of Birth YarmouthCounty of Yarmouth

Name of Father Ernest Feener MAIDEN NAME of Mother mary Ellen Nixon

Residence of Father when child was born Liverpool, Queens Co., NS Present address of Father Portland, Maine, USA

Occupation of Father at Birth of child Fisherman Place of birth of Father Liverpool, Queens Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Ellen Nixon Address of Applicant Portland, Maine, USA Date 30 July 1936

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gertrude JaneFeener

Born at Yarmouth in the County of Yarmouth

That Gertrude JaneFeener Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on June 20, 1921

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

Being her mother have full knowledge of the facts in connection with the above birth.

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