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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000953

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marion GertrudeDavis Sex Female

Date of Birth October 19, 1923 Place of Birth yarmouthCounty of Yarmouth

Name of Father Joseph Henery Davis MAIDEN NAME of Mother Marion Jeannetta Townsend

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

Residence of Father when child was born Yarmouth Ns Present address of Father Deceased

Occupation of Father at Birth of child Place of birth of Father Shelburne, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Marion Gertrude Swift Address of Applicant Westport, Digby Co., NS Date 5 October 1985

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marion GertrudeDavis

Born at yarmouth in the County of Yarmouth

That Marion GertrudeDavis Whose Birth is sought to be registered was

born at yarmouth Yarmouth County on October 19, 1923

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

Applicant is my natural daughter

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