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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000880

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Roma PearlDorey Sex Female

Date of Birth August 5, 1923 Place of Birth New CornwallCounty of Lunenburg

Name of Father Daniel Albert Dorey MAIDEN NAME of Mother Mary Alice Bruhm

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

Residence of Father when child was born New Cornwall Lunenburg Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Clearland, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Roma Pearl McGregor Address of Applicant Deep Brook, Annapolis Co., NS Date 11 November 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Roma PearlDorey

Born at New Cornwall in the County of Lunenburg

That Roma PearlDorey Whose Birth is sought to be registered was

born at New Cornwall Lunenburg County on August 5, 1923

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

As told by my mother

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