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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000148

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of rita MatildaMills Sex Female

Date of Birth April 14, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Harry Joseph Mills MAIDEN NAME of Mother Theresa McInnis

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

Residence of Father when child was born Sydney, Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Barber Place of birth of Father Prince Edward Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Rita M. Mills Wallace Address of Applicant 63 Boem Avenue, Wexford Post Office, Ontario Date 9 July 1954

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of rita MatildaMills

Born at Sydney in the County of Cape Breton

That rita MatildaMills Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 14, 1924

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

I am the mother of the said Rita Matilda Mills

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