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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000041

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth June 15, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Edward Chaisson MAIDEN NAME of Mother Annie Isabelle Adams

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

Residence of Father when child was born Halifax Present address of Father Tufts Cove

Occupation of Father at Birth of child Able Seaman Place of birth of Father Magdaline Islands

Race French Name and present address of Physician in attendance at birth Dr. J.N. McTumos

Signature of Applicant Anna Isobel Chaisson Address of Applicant Tufts Cove Date February 7, 1946

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Halifax in the County of Halifax

That George WilliamChaisson Whose Birth is sought to be registered was

born at Halifax Halifax County on June 15, 1921

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

I am her mother

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