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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000285

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Hazel AmeliaCleary Sex Female

Date of Birth April 13, 1923 Place of Birth Eastern PassageCounty of Halifax

Name of Father William Cleary MAIDEN NAME of Mother Elva York

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

Residence of Father when child was born Sable Island Shelburne Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Lighthouse Keeper Place of birth of Father Eastern Passage, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Herbert Cornelius Brown Address of Applicant Eastern Passage, Halifax Co., NS Date 25 February 1963

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Hazel AmeliaCleary

Born at Eastern Passage in the County of Halifax

That Hazel AmeliaCleary Whose Birth is sought to be registered was

born at Eastern Passage Halifax County on April 13, 1923

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

Baptismal certificate issued to above at St. Peters Church, Eastern Passage, shows above person born on such a day at that place.

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