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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000001

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Pauline RoseChurch Sex Female

Date of Birth May 30, 1924 Place of Birth 96 Windsor Street, HalifaxCounty of Halifax

Name of Father Loren B. Church MAIDEN NAME of Mother Pauline Mills

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

Residence of Father when child was born Halifax Present address of Father Chester

Occupation of Father at Birth of child Engineer Place of birth of Father Chester

Race Name and present address of Physician in attendance at birth

Signature of Applicant Harriet Bent Zinck Address of Applicant Box 104, Chester, Lunenburg Co., NS Date 27 June 1946

Relationship of Applicant to child Aunt

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Pauline RoseChurch

Born at 96 Windsor Street, Halifax in the County of Halifax

That Pauline RoseChurch Whose Birth is sought to be registered was

born at 96 Windsor Street, Halifax Halifax County on May 30, 1924

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

I am an Aunt of Pauline Rose Church. I was in Chester at the time of birth and was advised by telephone of the birth and later (2 hours) of death of the mother. I remember the date as being May 30th, 1924

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