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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000969

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clara MadeleineThomas Sex Female

Date of Birth March 7, 1923 Place of Birth ShubenacadieCounty of Hants

Name of Father Frank Thomas MAIDEN NAME of Mother Matilda Sack

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

Residence of Father when child was born Shubenacadie Hants Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Shubenacadie, Hants Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Clarence Knockwood Address of Applicant Shubenacadie, Hants Co., NS Date 15 September 1986

Relationship of Applicant to child Cousin

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clara MadeleineThomas

Born at Shubenacadie in the County of Hants

That Clara MadeleineThomas Whose Birth is sought to be registered was

born at Shubenacadie Hants County on March 7, 1923

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

Baptismal

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