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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000471

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lela IreneTerry Sex Female

Date of Birth September 15, 1923 Place of Birth TruroCounty of Colchester

Name of Father Wilbert Anderson Terry MAIDEN NAME of Mother Violet Lily May Matthew

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

Residence of Father when child was born Truro Present address of Father

Occupation of Father at Birth of child Place of birth of Father West New Annan, Colchester Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lela Irene Terry Address of Applicant 512 Egerton Street, London, Ontario Date April 1973

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lela IreneTerry

Born at Truro in the County of Colchester

That Lela IreneTerry Whose Birth is sought to be registered was

born at Truro Colchester County on September 15, 1923

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

I am Lela Irene Terry's cousin and have known her from the day she was born. I was born 1910 & have lived thirty miles from her place of birth - Truro. Signed Edith Gertrude Terry, West New Annan, Colchester Co., NS

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