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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000682

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 23, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father George William Lewis MAIDEN NAME of Mother Bertha Fraser

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

Residence of Father when child was born Taylor Street Sydney Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Mechanic Place of birth of Father Summerside, Prince Edward Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edward H. Lewis Address of Applicant 719 Sunny Point Drive, Newmarket, Ontario Date 11 October 1978

Relationship of Applicant to child Applicant is child

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That Edward HenryLewis Whose Birth is sought to be registered was

born at Sydney Cape Breton County on July 23, 1923

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

See Schedules "A" & "B" attached

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