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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000537

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bernice LeoniaKynock Sex Female

Date of Birth January 22, 1924 Place of Birth Forest HomeCounty of Kings

Name of Father George William Kynock MAIDEN NAME of Mother Pearl Ethel Butler

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father Forest Home, Kings Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Bernice Leonia Welton Address of Applicant RR #1, Kentville, Kings Co., NS Date

Relationship of Applicant to child 3 March 1977

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bernice LeoniaKynock

Born at Forest Home in the County of Kings

That Bernice LeoniaKynock Whose Birth is sought to be registered was

born at Forest Home Kings County on January 22, 1924

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

Record in Family testament

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