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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000621

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Violet AnnieBrereton Sex Female

Date of Birth July 4, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father John Henry Place Brereton MAIDEN NAME of Mother Mary Elizabeth Mont

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 Able Seaman Place of birth of Father England

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Violet Robinson Address of Applicant 77 School Avenue, Halifax, NS Date 29 November 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Violet AnnieBrereton

Born at Halifax in the County of Halifax

That Violet AnnieBrereton Whose Birth is sought to be registered was

born at Halifax Halifax County on July 4, 1923

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

Baptismal Marriage records

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