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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600756

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of GloriaMisener Sex Female

Date of Birth March 5, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father William Misener MAIDEN NAME of Mother Ida Dauphinee

Residence of Father when child was born Halifax, NS Present address of Father Unknown

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Rosa L. Davis Address of Applicant 32 Stone Street, Auburn, Massachusetts, USA Date 11 July 1938

Relationship of Applicant to child Adopted Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of GloriaMisener

Born at Halifax in the County of Halifax

That GloriaMisener Whose Birth is sought to be registered was

born at Halifax Halifax County on March 5, 1923

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

That I have had her since she was four months of age and am sure of the date of her birth.

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