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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700013

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth August 30, 1923 Place of Birth South OhioCounty of Yarmouth

Name of Father Arnold H. Moses MAIDEN NAME of Mother Lydia S. Ellis

Residence of Father when child was born South Ohio, Yarmouth Co., NS Present address of Father Dayton

Occupation of Father at Birth of child Butcher Place of birth of Father Yarmouth, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Arnold H. Moses Address of Applicant Dayton, Yarmouth Co., NS Date 23 October 1942

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at South Ohio in the County of Yarmouth

That ElizabethMoses Whose Birth is sought to be registered was

born at South Ohio Yarmouth County on August 30, 1923

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

Father of child and was present at birth

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