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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000073

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clifford ThomasRafuse Sex Male

Date of Birth June 15, 1923 Place of Birth BridgewaterCounty of Lunenburg

Name of Father Joshua Isreal Rafuse MAIDEN NAME of Mother Mary Meadie Penney

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Bridgewater Lunenburg Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Section Man Place of birth of Father Gold River, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Meadie Schwartz Address of Applicant Bridgewater, Lunenburg Co., NS Date 24 April 1948

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clifford ThomasRafuse

Born at Bridgewater in the County of Lunenburg

That Clifford ThomasRafuse Whose Birth is sought to be registered was

born at Bridgewater Lunenburg County on June 15, 1923

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

That I am his mother and that I have the family bible record.

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