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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000315

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Velma MaeBurgess Sex Female

Date of Birth March 18, 1923 Place of Birth NoelCounty of Hants

Name of Father Clyde Watson Burgess MAIDEN NAME of Mother Erma Letitia Woodworth

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

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Hillsvale, Hants Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Erma L. Burgess Address of Applicant Noel, Hants Co., NS Date 15 April 1923

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Velma MaeBurgess

Born at Noel in the County of Hants

That Velma MaeBurgess Whose Birth is sought to be registered was

born at Noel Hants County on March 18, 1923

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

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