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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91900387

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anna Mary JosephineNicholson Sex Female

Date of Birth July 18, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Dan James R. Nicholson MAIDEN NAME of Mother Margaret O'Brien

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Long Island Main, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Margaret Nicholson Address of Applicant Judique, Inverness Co., NS Date 24 February 1945

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anna Mary JosephineNicholson

Born at Glace Bay in the County of Cape Breton

That Anna Mary JosephineNicholson Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on July 18, 1922

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

Enclosed certificate of Baptism

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