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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000432

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Susan MargaretBurns Sex Female

Date of Birth December 16, 1924 Place of Birth DartmouthCounty of Halifax

Name of Father John William Burns MAIDEN NAME of Mother Margaret Langille

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

Residence of Father when child was born Dartmouth, NS Present address of Father Deceased

Occupation of Father at Birth of child Steward Place of birth of Father Lunenburg, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Susan Margaret Foggoa Address of Applicant 83 Jackson Road, Dartmouth, NS Date 17 July 1974

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Susan MargaretBurns

Born at Dartmouth in the County of Halifax

That Susan MargaretBurns Whose Birth is sought to be registered was

born at Dartmouth Halifax County on December 16, 1924

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

Self. See attached certificate of Baptism

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