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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000930

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lloyd SterlingMatheson Sex Male

Date of Birth August 9, 1921 Place of Birth AlbaCounty of Inverness

Name of Father Kenneth A. Matheson MAIDEN NAME of Mother Effie Jessie MacLeod

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

Residence of Father when child was born Alba Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lloyd Matheson Address of Applicant Little Narrows Date February 6, 1981

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lloyd SterlingMatheson

Born at Alba in the County of Inverness

That Lloyd SterlingMatheson Whose Birth is sought to be registered was

born at Alba Inverness County on August 9, 1921

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

I was at the home of my cousin, Kenneth Matheson, at Alba on August 9, 1921 when Lloyd was born.

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