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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000749

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Evelyn BlancheKiley Sex Female

Date of Birth May 11, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father James Kiley MAIDEN NAME of Mother Stella Blanche Young

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

Residence of Father when child was born 592 Roost Street, Glace Bay, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Electrician Place of birth of Father Sydney, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Evelyn B. Yorke Address of Applicant 3 Campbell Lane, Glace Bay, Cape Breton Date 23 April 1979

Relationship of Applicant to child Done by applicant herself

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Evelyn BlancheKiley

Born at Glace Bay in the County of Cape Breton

That Evelyn BlancheKiley Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 11, 1922

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

I have lived at 615 Roost Street, Glace Bay for 66 years and was neighbor and close friend of Evelyn Blanche Kiley and her family. I believe that she is the age that is given on her baptismal certificate.

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