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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600256

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gordon LevernAtkinson Sex Male

Date of Birth November 2, 1920 Place of Birth Stony IslandCounty of Shelburne

Name of Father Edgar Vance Atkinson MAIDEN NAME of Mother Mariam Cunningham

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

Residence of Father when child was born Stony Island, Shelburne Co. Present address of Father Stony Island, Shelburne Co.

Occupation of Father at Birth of child Fisherman Place of birth of Father United States

Race English Name and present address of Physician in attendance at birth Dr. R. Brown and nurse Mrs. S. A. Nickerson

Signature of Applicant Mrs. William W. Brannen Address of Applicant Stony Island, Shelburne Co. Date 18 March 1933

Relationship of Applicant to child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gordon LevernAtkinson

Born at Stony Island in the County of Shelburne

That Gordon LevernAtkinson Whose Birth is sought to be registered was

born at Stony Island Shelburne County on November 2, 1920

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

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