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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800096

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mildred MayClarke Sex Female

Date of Birth December 22, 1921 Place of Birth Lower GranvilleCounty of Annapolis

Name of Father James Vernon Clarke MAIDEN NAME of Mother Sarah Caroline Mills

Residence of Father when child was born Lower Granville, Annapolis Co., NS Present address of Father Lower Granville, Annapolis Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Lower Granville, Annapolis Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Atlanta Clarke Address of Applicant HMCS Stadacona, Halifax Date August 31, 1944

Relationship of Applicant to child Older sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mildred MayClarke

Born at Lower Granville in the County of Annapolis

That Mildred MayClarke Whose Birth is sought to be registered was

born at Lower Granville Annapolis County on December 22, 1921

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

I am her old sister Certificate of Baptism attached

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