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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000253

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mervin JamesStagg Sex Male

Date of Birth February 29, 1924 Place of Birth North SydneyCounty of Cape Breton

Name of Father William Joseph Stagg MAIDEN NAME of Mother Mildred Davidge

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

Residence of Father when child was born North Sydney, Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Coal Trimmer Place of birth of Father Fortune Bay, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mildred Stagg Address of Applicant 486 Purves Street, North Sydney, Cape Breton Co., NS Date 29 August 1962

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mervin JamesStagg

Born at North Sydney in the County of Cape Breton

That Mervin JamesStagg Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on February 29, 1924

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

I am the mother of the said Mervin James Stagg and am positive that the said date of birth is the correct one

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