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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000512

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of George EdwardKeddy Sex Male

Date of Birth June 30, 1920 Place of Birth Forties SettlementCounty of Lunenburg

Name of Father Edward James Keddy MAIDEN NAME of Mother Loretta Bezanson

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

Residence of Father when child was born Forties Settlement Present address of Father Forties Settlement

Occupation of Father at Birth of child Farmer Place of birth of Father Lake Ramsay

Race English Name and present address of Physician in attendance at birth Dr. F.C. Lavers, deceased

Signature of Applicant Mrs. Loretta Keddy Address of Applicant New Ross Date august 18, 1969

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of George EdwardKeddy

Born at Forties Settlement in the County of Lunenburg

That George EdwardKeddy Whose Birth is sought to be registered was

born at Forties Settlement Lunenburg County on June 30, 1920

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

I am the mother of George Edward Keddy. Both parents are living.

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