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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000908

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Hannah PearlWhite Sex Female

Date of Birth August 2, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father Samuel White MAIDEN NAME of Mother Laura Jane Thistle

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

Residence of Father when child was born Glace Bay Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Hannah Pearl Dickson Address of Applicant 1204 Alexandra Street, Sydney, Cape Breton Co., NS Date 23 November 1982

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Hannah PearlWhite

Born at Glace Bay in the County of Cape Breton

That Hannah PearlWhite Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on August 2, 1923

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

Information received from _________?

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