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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100015

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Parker StanleyJordan Sex Male

Date of Birth June 20, 1921 Place of Birth SonoraCounty of Guysborough

Name of Father Asa Albert Jordan MAIDEN NAME of Mother Edna Verena Burns

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

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant R.C. Kaiser Address of Applicant 8734 99th Ave. Port Saskatchewan, Alberta Date June 20, 1983

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Parker StanleyJordan

Born at Sonora in the County of Guysborough

That Parker StanleyJordan Whose Birth is sought to be registered was

born at Sonora Guysborough County on June 20, 1921

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

Baptism

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