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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000002

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gloria MayCromwell Sex Female

Date of Birth October 27, 1924 Place of Birth Weymouth FallsCounty of Digby

Name of Father Sydney Allen Cromwell MAIDEN NAME of Mother Gertrude May Pleasant

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

Residence of Father when child was born Weymouth Falls Present address of Father Weymouth Falls

Occupation of Father at Birth of child Labourer Place of birth of Father Weymouth Falls

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Sidney Cromwell Address of Applicant Weymouth Falls Date 30 July 1946

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gloria MayCromwell

Born at Weymouth Falls in the County of Digby

That Gloria MayCromwell Whose Birth is sought to be registered was

born at Weymouth Falls Digby County on October 27, 1924

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

I am the mother of said Gloria May Cromwell

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