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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000561

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of HelenKelley Sex Female

Date of Birth August 9, 1923 Place of Birth ShubenacadieCounty of Hants

Name of Father George Kelley MAIDEN NAME of Mother  Caddell

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

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

Occupation of Father at Birth of child Labourer Place of birth of Father Shubenacadie, Hants Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Helen Wyer Address of Applicant Box 31, Shubenacadie, Hants Co., NS Date

Relationship of Applicant to child Self Registration

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of HelenKelley

Born at Shubenacadie in the County of Hants

That HelenKelley Whose Birth is sought to be registered was

born at Shubenacadie Hants County on August 9, 1923

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

Registration in Shubenacadie East School Section No. 43, Register on 30 June 1930, age recorded as 6 years 10 months and 21 days. Census

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