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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000340

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Margaret HelenWorth Sex Female

Date of Birth January 2, 1923 Place of Birth GuysboroughCounty of Guysborough

Name of Father Patrick Worth MAIDEN NAME of Mother Alice Pelly

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

Residence of Father when child was born Guysborough Ns Present address of Father Guysborough, NS

Occupation of Father at Birth of child Farmer Place of birth of Father Guysborough, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Margaret Helen Worth Address of Applicant 671 Queen Street West, Toronto, ON Date 24 May 1968

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Margaret HelenWorth

Born at Guysborough in the County of Guysborough

That Margaret HelenWorth Whose Birth is sought to be registered was

born at Guysborough Guysborough County on January 2, 1923

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

I am basing my facts of my birth on my certificate of Baptism

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