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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000425

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Edison LeslieStevens Sex Male

Date of Birth February 21, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father Howard Leslie Stevens MAIDEN NAME of Mother Phoebe Jane MacDonald

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

Residence of Father when child was born Glace Bay Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Miner Place of birth of Father Tancook Island, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edison Leslie Stevens Address of Applicant 41 Bordon Street, Glace Bay, Cape Breton Co., NS Date 19 January 1972

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Edison LeslieStevens

Born at Glace Bay in the County of Cape Breton

That Edison LeslieStevens Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on February 21, 1923

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

I am an older brother of Edison Leslie Stevens and am aware of particulars of his birth as set forth herein.

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