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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000508

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of VernardAdshade Sex Male

Date of Birth August 7, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father Vernard  Adshade MAIDEN NAME of Mother Annie May MacDonald

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

Residence of Father when child was born Glace Bay Present address of Father deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Amherst

Race British Name and present address of Physician in attendance at birth Dr. A. MacAskill, deceased

Signature of Applicant Vernard Adshade Address of Applicant Preston, Ontario Date February 18, 1970

Relationship of Applicant to child self

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That VernardAdshade Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on August 7, 1920

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

As I am the Mother of Vernard Adshade of 339 Margaret Street, Preston, Ontario who seeks this Registration and certificate.

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