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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800693

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Myra LouiseYoung Sex Female

Date of Birth January 13, 1923 Place of Birth LiverpoolCounty of Queens

Name of Father Albert E. Young MAIDEN NAME of Mother Beatrice Jacklyn

Residence of Father when child was born Liverpool, Queens Co., NS Present address of Father Liverpool, Queens Co., NS

Occupation of Father at Birth of child Blacksmith Place of birth of Father Liverpool, Queens Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edith Nina Bennett Address of Applicant Liverpool, Queens Co., NS Date 17 August 1944

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Myra LouiseYoung

Born at Liverpool in the County of Queens

That Myra LouiseYoung Whose Birth is sought to be registered was

born at Liverpool Queens County on January 13, 1923

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

Physicians certificate attached

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