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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000556

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary AdeleNoah Sex Female

Date of Birth June 21, 1923 Place of Birth YarmouthCounty of Yarmouth

Name of Father Dominic Noah MAIDEN NAME of Mother Mary Rose Moulaison

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

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

Occupation of Father at Birth of child Merchant Place of birth of Father Beirut, Lebanon

Race Name and present address of Physician in attendance at birth

Signature of Applicant Clyde J. Nicholson Address of Applicant 68 Nichols Avenue, Kentville, Kings Co., NS Date 30 January 1976

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary AdeleNoah

Born at Yarmouth in the County of Yarmouth

That Mary AdeleNoah Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on June 21, 1923

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

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