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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000379

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Claude EverettCrouse Sex Male

Date of Birth March 23, 1923 Place of Birth ChelseaCounty of Lunenburg

Name of Father Eli Parker Crouse MAIDEN NAME of Mother Jennie Mae Crouse

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

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

Occupation of Father at Birth of child Farmer Place of birth of Father Chelsea, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Anita Cranton Address of Applicant Chelsea, Lunenburg Co., NS Date 18 February 1970

Relationship of Applicant to child Cousin

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Claude EverettCrouse

Born at Chelsea in the County of Lunenburg

That Claude EverettCrouse Whose Birth is sought to be registered was

born at Chelsea Lunenburg County on March 23, 1923

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

Census National Registration record

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