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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91600574

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Isabell MayAgnew Sex Female

Date of Birth May 15, 1921 Place of Birth River HebertCounty of Cumberland

Name of Father John Agnew MAIDEN NAME of Mother Flora Ella Shirley

Residence of Father when child was born River Hebert, Cumberland Co., NS Present address of Father River Hebert, Cumberland Co., NS

Occupation of Father at Birth of child Miner Place of birth of Father Main River, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Flora Agnew Address of Applicant River Hebert, Cumberland Co., NS Date 23 January 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Isabell MayAgnew

Born at River Hebert in the County of Cumberland

That Isabell MayAgnew Whose Birth is sought to be registered was

born at River Hebert Cumberland County on May 15, 1921

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

I am the mother of the above child Isabell May Agnew

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