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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000922

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Susan BernadetteDaisley Sex Female

Date of Birth August 28, 1924 Place of Birth South HarbourCounty of Victoria

Name of Father David J. Daisley MAIDEN NAME of Mother Anne Mary MacDonald

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

Residence of Father when child was born South Harbour Present address of Father deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father South Harbour

Race Name and present address of Physician in attendance at birth

Signature of Applicant Susan Bernadette Daisley Address of Applicant White Point Date September 9, 1988

Relationship of Applicant to child same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Susan BernadetteDaisley

Born at South Harbour in the County of Victoria

That Susan BernadetteDaisley Whose Birth is sought to be registered was

born at South Harbour Victoria County on August 28, 1924

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

That I lived next door to this lady and I'm familiar to her and her Birth. I do truthfully state her statement is correct. D.A. MacDonald.

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