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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000717

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth March 11, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother  Casey

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

Residence of Father when child was born Present address of Father

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 Fay Jablonowski Address of Applicant 683 Shaw Street, Toronto, Ontario Date 12 March 1979

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Halifax in the County of Halifax

That Mary FayCasey Whose Birth is sought to be registered was

born at Halifax Halifax County on March 11, 1923

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

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