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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000334

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 22, 1923 Place of Birth Martins PointCounty of Lunenburg

Name of Father William Edward Rafuse MAIDEN NAME of Mother Bertha May Vaughn

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

Residence of Father when child was born Martins Point Lunenburg Co. Ns Present address of Father Martins Point, Lunenburg Co., NS

Occupation of Father at Birth of child Fisherman Place of birth of Father Martins Point, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Bertha May Rafuse Address of Applicant Martins Point, Lunenburg Co., NS Date 23 March 1968

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Martins Point in the County of Lunenburg

That Edward ThomasRafuse Whose Birth is sought to be registered was

born at Martins Point Lunenburg County on July 22, 1923

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

Certificate of Baptism from the records of St. Martin's Parish at Western Shore as "Class A" evidence. I am his mother and can therefor verify the date of birth.

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