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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

36800316

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Margery LucindaShupe Sex Female

Date of Birth August 2, 1924 Place of Birth Lake AnnisCounty of Yarmouth

Name of Father Robert Condgon Shupe MAIDEN NAME of Mother Edith Grace Spavold

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

Residence of Father when child was born Lake Annis, Yarmouth Co., NS Present address of Father

Occupation of Father at Birth of child Farmer Place of birth of Father Lake Annis, Yarmouth Co., NSShelburne County

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edith G. Shupe Address of Applicant Lake Annis, Yarmouth Co., NS Date 29 August 1924

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Margery LucindaShupe

Born at Lake Annis in the County of Yarmouth

That Margery LucindaShupe Whose Birth is sought to be registered was

born at Lake Annis Yarmouth County on August 2, 1924

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

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