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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000968

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean ElizabethBrown Sex Female

Date of Birth August 30, 1924 Place of Birth Montague MinesCounty of Halifax

Name of Father John Murray Brown MAIDEN NAME of Mother Maud Catheren Vaughan

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

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father Cariboo Mines

Race Name and present address of Physician in attendance at birth

Signature of Applicant Debby Lee Burgess Address of Applicant 561 Cottonwood Ave. Coquitlam, British Columbia Date November 27, 1989

Relationship of Applicant to child Daughter

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean ElizabethBrown

Born at Montague Mines in the County of Halifax

That Jean ElizabethBrown Whose Birth is sought to be registered was

born at Montague Mines Halifax County on August 30, 1924

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

(please read my letter enclosed!!)

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