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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91600370

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Elaine WatsonNeily Sex Female

Date of Birth August 5, 1922 Place of Birth Torbrook MinesCounty of Annapolis

Name of Father Charles Murray Neily MAIDEN NAME of Mother Annie Sarah Watson

Residence of Father when child was born Dead Present address of Father Dead

Occupation of Father at Birth of child Dead Place of birth of Father Torbrook Mines, Annapolis Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Annie S. Mapplebeck Address of Applicant Margaretsville, Annapolis Co., NS Date 28 November 1941

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Elaine WatsonNeily

Born at Torbrook Mines in the County of Annapolis

That Elaine WatsonNeily Whose Birth is sought to be registered was

born at Torbrook Mines Annapolis County on August 5, 1922

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

I am the mother of Elaine Watson Neily

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