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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000432

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carmen MadelineMartin Sex Female

Date of Birth October 31, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father Harry Roy Martin MAIDEN NAME of Mother Lucy Ardella Little

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

Residence of Father when child was born Halifax Ns Present address of Father Deceased

Occupation of Father at Birth of child Unknown Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. N. E. Johnstone Address of Applicant 5225 Lockman Avenue, Halifax, NS Date 26 April 1972

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carmen MadelineMartin

Born at Halifax in the County of Halifax

That Carmen MadelineMartin Whose Birth is sought to be registered was

born at Halifax Halifax County on October 31, 1923

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

Certificate of Baptism

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