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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000248

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Eve PatrickChiasson Sex Male

Date of Birth March 15, 1923 Place of Birth Reserve MinesCounty of Cape Breton

Name of Father Claude Chiasson MAIDEN NAME of Mother Marie Chiasson

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

Residence of Father when child was born Reserve Mines Cape Breton Co. Ns Present address of Father Reserve Mines, Cape Breton Co., NS

Occupation of Father at Birth of child Coal Miner Place of birth of Father Cheticamp, Inverness Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Agnes Chiasson Address of Applicant Reserve Mines, Cape Breton Co., NS Date 19 December 1959

Relationship of Applicant to child Wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Eve PatrickChiasson

Born at Reserve Mines in the County of Cape Breton

That Eve PatrickChiasson Whose Birth is sought to be registered was

born at Reserve Mines Cape Breton County on March 15, 1923

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

It is the date shown on the certificate of baptism taken from the records of St. Joseph's Church, Reserve Mines, Cape Breton Co., NS which is attached herewith.

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