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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000370

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Margaret AnnLewis Sex Female

Date of Birth December 23, 1924 Place of Birth CoxheathCounty of Cape Breton

Name of Father   MAIDEN NAME of Mother Pearl Mae Lewis

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Margaret Shellnutt Address of Applicant 31 Helene Avenue, Dartmouth, NS Date 14 April 1972

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Margaret AnnLewis

Born at Coxheath in the County of Cape Breton

That Margaret AnnLewis Whose Birth is sought to be registered was

born at Coxheath Cape Breton County on December 23, 1924

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

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