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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600322

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Edson JamesTheriault Sex Male

Date of Birth August 23, 1922 Place of Birth East FerryCounty of Digby

Name of Father John Daley Theriault MAIDEN NAME of Mother Eva Dennis

Residence of Father when child was born East Ferry, Digby Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father East Ferry, Digby Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Eva Theriault Address of Applicant 199 1/2 Bank Street, Ottawa, Ontario Date 14 August 1935

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Edson JamesTheriault

Born at East Ferry in the County of Digby

That Edson JamesTheriault Whose Birth is sought to be registered was

born at East Ferry Digby County on August 23, 1922

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

I am his mother

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