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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100183

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of EdwardSisco Sex Male

Date of Birth December 23, 1921 Place of Birth YarmouthCounty of Yarmouth

Name of Father Englis Raymond Sisco MAIDEN NAME of Mother Viola Kellen

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

Residence of Father when child was born Yarmouth Present address of Father

Occupation of Father at Birth of child Labour Construction Place of birth of Father Yarmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edward Sisco Address of Applicant 1803 St. Jacques Montreal, Quebec Date 19 June 1986

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of EdwardSisco

Born at Yarmouth in the County of Yarmouth

That EdwardSisco Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on December 23, 1921

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

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