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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91800183

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Phyllis MarieMorrison Sex Female

Date of Birth March 1, 1921 Place of Birth Kempt HeadCounty of Victoria

Name of Father William Kenzie Morrison MAIDEN NAME of Mother Clara McBirney

Residence of Father when child was born Kempt Head, Victoria Co., NS Present address of Father Kempt Head, Victoria Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Kempt Head, Victoria Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant W. K. Morrison Address of Applicant Kempt Head, Victoria Co., NS Date 21 March 1941

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Phyllis MarieMorrison

Born at Kempt Head in the County of Victoria

That Phyllis MarieMorrison Whose Birth is sought to be registered was

born at Kempt Head Victoria County on March 1, 1921

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

Is found in the family records and I therefore know the exact date of her birth and place she was born as set forth herein. I hereby certify that I examined W. K. Morrison's family bible record and can state that the above record is a true copy. Signed Philip J. Macaulay, Justice of the Peace.

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