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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000053

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Audrey CatehrineSampson Sex Female

Date of Birth March 22, 1924 Place of Birth Lower L'ArdoiseCounty of Richmond

Name of Father Albert P. Sampson MAIDEN NAME of Mother Dorothy Crowley

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

Residence of Father when child was born Lower L'Ardoise, Richmond Co., NS Present address of Father Lower L'Ardoise, Richmond Co., NS

Occupation of Father at Birth of child Fish Buyer Place of birth of Father Lower L'Ardoise, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Audrey Catherine Sampson Address of Applicant 33 Newton Avenue, Halifax, NS Date 14 July 1947

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Audrey CatehrineSampson

Born at Lower L'Ardoise in the County of Richmond

That Audrey CatehrineSampson Whose Birth is sought to be registered was

born at Lower L'Ardoise Richmond County on March 22, 1924

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

I am her older sister and know that she was born on March 22, 1924

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