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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93501644

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Edwin CrosbyCook Sex Male

Date of Birth May 1, 1906 Place of Birth Pleasant ValleyCounty of Yarmouth

Name of Father Caleb Cook MAIDEN NAME of Mother Eliza Jane Wetmore

Residence of Father when child was born Pleasant Valley Present address of Father Centreville

Occupation of Father at Birth of child Farmer Place of birth of Father Yarmouth

Race white Name and present address of Physician in attendance at birth Dr. S.W. Williamson

Signature of Applicant Edwin Crosby Cook Address of Applicant Centreville Date 14 June 1926

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Edwin CrosbyCook

Born at Pleasant Valley in the County of Yarmouth

That Edwin CrosbyCook Whose Birth is sought to be registered was

born at Pleasant Valley Yarmouth County on May 1, 1906

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

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