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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100097

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Florence CamillaRiley Sex Female

Date of Birth August 19, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father James Riley MAIDEN NAME of Mother Winnifred McDonald

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

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father Tignish, Prince Edward Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Carmel Eikeland Address of Applicant Crowder Blvd. Newmarket, Ontario Date December 7, 2007

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Florence CamillaRiley

Born at Glace Bay in the County of Cape Breton

That Florence CamillaRiley Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on August 19, 1923

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

Baptismal Certificate

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