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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000609

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mildred DorothyMeisner Sex Female

Date of Birth January 5, 1924 Place of Birth Conquerall MillsCounty of Lunenburg

Name of Father Justus Meisner MAIDEN NAME of Mother Hilda Cross

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

Residence of Father when child was born Conquerall Mills, Lunenburg Co., NS Present address of Father Conquerall Mills, Lunenburg Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Lake Centre, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mildred Dorothy Meisner Address of Applicant Auburndale, Lunenburg Co., NS Date 24 January 1979

Relationship of Applicant to child One and same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mildred DorothyMeisner

Born at Conquerall Mills in the County of Lunenburg

That Mildred DorothyMeisner Whose Birth is sought to be registered was

born at Conquerall Mills Lunenburg County on January 5, 1924

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

Baptism certificate duly certified Marriage certificate duly certified

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