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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000796

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Emerad LesterDorey Sex Male

Date of Birth July 13, 1923 Place of Birth Upper WaldonCounty of Lunenburg

Name of Father Archibald Dorey MAIDEN NAME of Mother Jennie Mae Naas

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

Residence of Father when child was born Upper Waldon Lunenburg Co. Ns Present address of Father Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jennie Mae Dorey Address of Applicant Newburne, Lunenburg Co., NS Date 6 December 1980

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Emerad LesterDorey

Born at Upper Waldon in the County of Lunenburg

That Emerad LesterDorey Whose Birth is sought to be registered was

born at Upper Waldon Lunenburg County on July 13, 1923

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

I am the mother of the Emerad Lester Dorey and have personal knowledge of the date and place of his birth

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