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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000583

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean MillicentMetherall Sex Female

Date of Birth June 24, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father James McCathy Metherall MAIDEN NAME of Mother Jessie Jane Stone

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

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Alberton, Prince Edward Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jean Millicent Metherall Address of Applicant 86 Trelawn, Welland, Ontario Date 5 August 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean MillicentMetherall

Born at Halifax in the County of Halifax

That Jean MillicentMetherall Whose Birth is sought to be registered was

born at Halifax Halifax County on June 24, 1923

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

Mother of Jean Millicent Metherall and baptized as per attached certificate.

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