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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000746

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen MayJollimore Sex Female

Date of Birth December 2, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father William Herman Jollimore MAIDEN NAME of Mother Agnes May Glazebrook

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 Labourer Place of birth of Father Terence Bay, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant V. McAvoy Address of Applicant 3546 Windsor Street, Halifax, NS Date 10 September 1979

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen MayJollimore

Born at Halifax in the County of Halifax

That Helen MayJollimore Whose Birth is sought to be registered was

born at Halifax Halifax County on December 2, 1923

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

Baptismal & marriage extract

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