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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000790

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rita FrancesAllen Sex Female

Date of Birth October 5, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Wilson Allen MAIDEN NAME of Mother Mary Moulton

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

Residence of Father when child was born South Bar Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Burin, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Rita Drover Address of Applicant Site 5, Box 11, RR #`1, Sydney, Cape Breton Co., NS Date 17 September 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rita FrancesAllen

Born at Sydney in the County of Cape Breton

That Rita FrancesAllen Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 5, 1923

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

Baptismal Certificate on file in Office of Deputy Registrar General as per attached letter.

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