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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000767

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of MaryRoss Sex Female

Date of Birth October 21, 1924 Place of Birth ArisaigCounty of Antigonish

Name of Father   MAIDEN NAME of Mother Margaret Rose

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 Mary Ross Address of Applicant 106 College Street, Antigonish, NS Date 3 October 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of MaryRoss

Born at Arisaig in the County of Antigonish

That MaryRoss Whose Birth is sought to be registered was

born at Arisaig Antigonish County on October 21, 1924

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

As told by my mother and as in church baptism records

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