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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90700016

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ada IonaSears Sex Female

Date of Birth July 29, 1921 Place of Birth Woods HarbourCounty of Shelburne

Name of Father Kenneth Sears MAIDEN NAME of Mother Aveta Nickerson

Residence of Father when child was born Woods Harbour, Shelburne Co., NS Present address of Father Deceased in 1922

Occupation of Father at Birth of child Fisherman Place of birth of Father Woods Harbour, Shelburne Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Sadie V. Hines Address of Applicant 77 Jefferson Avenue, Everett, Massachusetts, USA Date 26 June 1937

Relationship of Applicant to child Adopted Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ada IonaSears

Born at Woods Harbour in the County of Shelburne

That Ada IonaSears Whose Birth is sought to be registered was

born at Woods Harbour Shelburne County on July 29, 1921

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

Her aunt informed me of the birth of child and a little later, the death of the father. I then went to Woods Harbour to adopt the baby, However instead of taking adoption papers there, I waited until I came back home and the papers went through in October 1923. I know all the circumstances at the time.

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