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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000390

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Beatrice CeceliaNickerson Sex Female

Date of Birth May 10, 1924 Place of Birth Little River HarbourCounty of Yarmouth

Name of Father Gordon John Nickerson MAIDEN NAME of Mother Ethel Cecelia Kenney

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

Residence of Father when child was born Deep Cove Island, Yarmouth Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Clarks Harbour, Shelburne Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Beatrice Cecelia Zarins Address of Applicant 27 Elm Street, Yarmouth, NS Date 4 January 1973

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Beatrice CeceliaNickerson

Born at Little River Harbour in the County of Yarmouth

That Beatrice CeceliaNickerson Whose Birth is sought to be registered was

born at Little River Harbour Yarmouth County on May 10, 1924

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

1. That I have read the certificate of Baptism attached herewith 2. N.B. That to the best of my knowledge and belief, I was born the illegitimate child of Gordon John Nickerson and Ethel Cecelia Kenney 3. That I was baptized under my mother's name but previous to my marriage, I always used my father's name

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