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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91900017

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen CatherineBates Sex Female

Date of Birth June 10, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father James J. Bates MAIDEN NAME of Mother Helena Mary Burke

Residence of Father when child was born Sydney, Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Manager, Sydney Branch of Furness Withy & Co., Ltd. Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Helena M. Bates Address of Applicant 81 Beech Street, Halifax, NS Date 17 January 1945

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen CatherineBates

Born at Sydney in the County of Cape Breton

That Helen CatherineBates Whose Birth is sought to be registered was

born at Sydney Cape Breton County on June 10, 1922

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

I am her mother

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