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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000262

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Florence Mary AileenEvans Sex Female

Date of Birth May 16, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father Lemuel James Evans MAIDEN NAME of Mother Mary Helen McLean

Residence of Father when child was born Present address of Father

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

Race Name and present address of Physician in attendance at birth Dr. Duffy

Signature of Applicant Aileen Evans Address of Applicant 444 Park St. West Windsor, Ontario Date October 1, 1958

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Florence Mary AileenEvans

Born at Glace Bay in the County of Cape Breton

That Florence Mary AileenEvans Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 16, 1921

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

That I am a sister of the applicant, Florence Mary Aileen Evans and have a personal knowledge of the facts herein deposed to. Baptism Record gives her third name incorrectly as Eileen Church Record and Hospital Record

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