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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000397

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Stella Mary CharlotteMiller Sex Female

Date of Birth August 4, 1924 Place of Birth YarmouthCounty of Yarmouth

Name of Father   MAIDEN NAME of Mother  

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 Stella Miller Address of Applicant Apt. 406, 188 Mill Street South, Brampton, Ontario Date 22 June 1973

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Stella Mary CharlotteMiller

Born at Yarmouth in the County of Yarmouth

That Stella Mary CharlotteMiller Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on August 4, 1924

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

This application is made for the registration of my own birth. Attached is a natural copy of Baptismal Certificate

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