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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000240

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Shirley EileenGibson Sex Female

Date of Birth January 20, 1924 Place of Birth YarmouthCounty of Yarmouth

Name of Father Fulton Gibson MAIDEN NAME of Mother Clara McGuire

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

Residence of Father when child was born Yarmouth, NS Present address of Father Deceased 7 December 1938

Occupation of Father at Birth of child Canadian National Railway Express Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Howard Bernard Gibson Address of Applicant 4453 Narvaez Crescent, Victoria, British Columbia Date 15 November 1961

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Shirley EileenGibson

Born at Yarmouth in the County of Yarmouth

That Shirley EileenGibson Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on January 20, 1924

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

My inspection of original certificate of Holy Baptism, which is attached herewith

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