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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92000749

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gladys MarjorieHamilton Sex Female

Date of Birth April 11, 1921 Place of Birth CarletonCounty of Yarmouth

Name of Father Leonard L. Hamilton MAIDEN NAME of Mother Leta Nickerson

Residence of Father when child was born Carleton, Yarmouth Co., NS Present address of Father Carleton, Yarmouth Co., NS

Occupation of Father at Birth of child Mill Hand Place of birth of Father Forest Glen, Yarmouth Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Leonard Hamilton Address of Applicant Carleton, Yarmouth Co., NS Date 14 March 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gladys MarjorieHamilton

Born at Carleton in the County of Yarmouth

That Gladys MarjorieHamilton Whose Birth is sought to be registered was

born at Carleton Yarmouth County on April 11, 1921

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

I am her mother and do well remember the date of her birth

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