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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700634

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Thelma KathleenHiltz Sex Female

Date of Birth January 6, 1922 Place of Birth Indian PointCounty of Lunenburg

Name of Father Roman William Hiltz MAIDEN NAME of Mother Laura Catherine Mosher

Residence of Father when child was born Indian Point, Lunenburg Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father Martins Point, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Roman Hiltz Address of Applicant Indian Point, Lunenburg Co., NS Date 25 September 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Thelma KathleenHiltz

Born at Indian Point in the County of Lunenburg

That Thelma KathleenHiltz Whose Birth is sought to be registered was

born at Indian Point Lunenburg County on January 6, 1922

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

I am the mother of the said Thelma K. Hiltz and as such, have full knowledge of the birth of the said child.

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