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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000669

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Vera LouiseWhite Sex Female

Date of Birth June 14, 1923 Place of Birth Country Harbour LakeCounty of Guysborough

Name of Father George White MAIDEN NAME of Mother Lillian Smith

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

Residence of Father when child was born Country Harbour Lake Guysborough Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lillian White Address of Applicant Country Harbour Lake, Guysborough Co., NS Date 29 May 1978

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Vera LouiseWhite

Born at Country Harbour Lake in the County of Guysborough

That Vera LouiseWhite Whose Birth is sought to be registered was

born at Country Harbour Lake Guysborough County on June 14, 1923

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

Recorded in family bible

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