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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000699

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ethel LorettaYoung Sex Female

Date of Birth October 4, 1921 Place of Birth Bras d'OrCounty of Cape Breton

Name of Father Lawrence Young MAIDEN NAME of Mother Eliza Fraser

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

Residence of Father when child was born Bras d'Or Present address of Father deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Bras d'Or

Race Name and present address of Physician in attendance at birth

Signature of Applicant Harry David Young Address of Applicant RR3 Bras d'Or Date May 19, 1977

Relationship of Applicant to child brother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ethel LorettaYoung

Born at Bras d'Or in the County of Cape Breton

That Ethel LorettaYoung Whose Birth is sought to be registered was

born at Bras d'Or Cape Breton County on October 4, 1921

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

Church Baptismal Record from St. Joseph's Parish, Bras d'Or

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