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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000208

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Fairfield KingsleyYoung Sex Male

Date of Birth October 26, 1921 Place of Birth Big Tancook IslandCounty of Lunenburg

Name of Father Gurney Ralph Young MAIDEN NAME of Mother Minerva May Slaunwhite

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

Residence of Father when child was born Big Tancook Island Present address of Father Big Tancook Island

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

Race German Name and present address of Physician in attendance at birth Dr. Arthur Delaney

Signature of Applicant Mrs. Minerva M. Young Address of Applicant 62 Myrtle Bank Ave. Dorchester, Massachusetts, USA Date June 30, 1955

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Fairfield KingsleyYoung

Born at Big Tancook Island in the County of Lunenburg

That Fairfield KingsleyYoung Whose Birth is sought to be registered was

born at Big Tancook Island Lunenburg County on October 26, 1921

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

I am her mother and recall the dates. School records show the date in error by seventeen days as October nine, 1921, the correct date being as stated above.

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