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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000553

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Annie LillianGomes Sex Female

Date of Birth January 8, 1924 Place of Birth HalifaxCounty of Halifax

Name of Father Claude Gomes MAIDEN NAME of Mother Blanche Rennie

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

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

Occupation of Father at Birth of child Place of birth of Father British Guiana (now Guyana)

Race Name and present address of Physician in attendance at birth

Signature of Applicant Annie L. Taylor Address of Applicant 29 Queensgrove Road, Scarborough, Ontario Date 24 October 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Annie LillianGomes

Born at Halifax in the County of Halifax

That Annie LillianGomes Whose Birth is sought to be registered was

born at Halifax Halifax County on January 8, 1924

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

Certificate of Baptism

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