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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000342

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Doris EvelynPelton Sex Female

Date of Birth July 30, 1924 Place of Birth WatervilleCounty of Kings

Name of Father Robie Pelton MAIDEN NAME of Mother Roxie Dykins

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

Residence of Father when child was born Waterville, Kings Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Berwick, Kings Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Doris Mauger Address of Applicant 6 Onondaga Street, Oromocto, NB Date 8 August 1970

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Doris EvelynPelton

Born at Waterville in the County of Kings

That Doris EvelynPelton Whose Birth is sought to be registered was

born at Waterville Kings County on July 30, 1924

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

I am an older brother

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