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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91600955

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Merrill McLeanLewis Sex Male

Date of Birth May 30, 1922 Place of Birth Point EdwardCounty of Cape Breton

Name of Father Stanley S. Lewis MAIDEN NAME of Mother Margaret M. Rudderham

Residence of Father when child was born Point Edward, Cape Breton Co., NS Present address of Father Point Edward, Cape Breton Co., NS

Occupation of Father at Birth of child Shipper Place of birth of Father Point Edward, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Margaret M. Lewis Address of Applicant Point Edward, Cape Breton Co., NS Date 9 June 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Merrill McLeanLewis

Born at Point Edward in the County of Cape Breton

That Merrill McLeanLewis Whose Birth is sought to be registered was

born at Point Edward Cape Breton County on May 30, 1922

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

I am his mother and the facts as recorded above are all correct

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