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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700921

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anne MariePettipas Sex Female

Date of Birth October 27, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Simon Pettipas MAIDEN NAME of Mother Mary Martell

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

Occupation of Father at Birth of child Seaman - Engineer Place of birth of Father Canada

Race Name and present address of Physician in attendance at birth

Signature of Applicant Beatrice Waldron Address of Applicant 314 Saratoga Street East, Boston, Massachusetts, USA Date 2 April 1943

Relationship of Applicant to child Paternal Aunt (sister to her father)

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anne MariePettipas

Born at Halifax in the County of Halifax

That Anne MariePettipas Whose Birth is sought to be registered was

born at Halifax Halifax County on October 27, 1921

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

A certificate of birth and baptism from church records attached to this application

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