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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000825

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Barbara MavisCorkum Sex Female

Date of Birth July 18, 1923 Place of Birth Port BickertonCounty of Guysborough

Name of Father Ira Judson Corkum MAIDEN NAME of Mother Winona Kirk

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

Residence of Father when child was born Port Bickerton 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 Barbara M. Marshall Address of Applicant Box 75, Bickerton West, Guysborough Co., NS Date 15 April 1982

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Barbara MavisCorkum

Born at Port Bickerton in the County of Guysborough

That Barbara MavisCorkum Whose Birth is sought to be registered was

born at Port Bickerton Guysborough County on July 18, 1923

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

As shown by census, marriage and National Registration records.

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