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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000323

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marguerite AgustaWillis Sex Female

Date of Birth May 14, 1924 Place of Birth YarmouthCounty of Yarmouth

Name of Father William Willis MAIDEN NAME of Mother Lydia Downey

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

Residence of Father when child was born North Preston, Halifax Co., NS Present address of Father North Preston, Halifax Co., NS

Occupation of Father at Birth of child Labourer Place of birth of Father North Preston, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Marguerite Willis-Lucas Address of Applicant 5182 Gray Street, Halifax, NS Date 12 May 1969

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marguerite AgustaWillis

Born at Yarmouth in the County of Yarmouth

That Marguerite AgustaWillis Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on May 14, 1924

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

Paper attached - Dem. Bureau of Statistics (Census) Paper attached - Halifax School Board

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