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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000291

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Emma MaySmith Sex Female

Date of Birth June 2, 1923 Place of Birth VaughanCounty of Hants

Name of Father Frederick M. Smith MAIDEN NAME of Mother Frances Redden

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

Residence of Father when child was born Vaughan Hants Co. Ns Present address of Father Vaughan, Hants Co., NS

Occupation of Father at Birth of child Lumberman Place of birth of Father Vaughan, Hants Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Fred Moody Smith Address of Applicant Vaughan, Hants Co., NS Date 12 July 1963

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Emma MaySmith

Born at Vaughan in the County of Hants

That Emma MaySmith Whose Birth is sought to be registered was

born at Vaughan Hants County on June 2, 1923

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

I am her father

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