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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000779

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jewel PaulineSelig Sex Female

Date of Birth May 16, 1924 Place of Birth West CliffordCounty of Lunenburg

Name of Father Frank Selig MAIDEN NAME of Mother Myra Bolliver

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

Residence of Father when child was born Baker Settlement, Lunenburg Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father East Clifford, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jewell P. Haughn Address of Applicant RR #7, Bridgewater, Lunenburg Co., NS Date 22 March 1984

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jewel PaulineSelig

Born at West Clifford in the County of Lunenburg

That Jewel PaulineSelig Whose Birth is sought to be registered was

born at West Clifford Lunenburg County on May 16, 1924

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

1. Extract from marriage record 2. School record

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