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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91900915

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gertrude MadelineSullivan Sex Female

Date of Birth May 14, 1922 Place of Birth HalifaxCounty of Halifax

Name of Father Ralph V. Sullivan MAIDEN NAME of Mother Alice M. Grey

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born 1074 Barrington Street, Halifax, NS Present address of Father 1 Black Street, Halifax, NS

Occupation of Father at Birth of child Plumber Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ralph V. Sullivan Address of Applicant 1 Black Street, Halifax, NS Date 9 October 1945

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gertrude MadelineSullivan

Born at Halifax in the County of Halifax

That Gertrude MadelineSullivan Whose Birth is sought to be registered was

born at Halifax Halifax County on May 14, 1922

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

Present at time of birth. Dates checked by baptismal certificate. I am the father of said Gertrude Madeline Sullivan.

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