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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000513

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of MinervaLewis Sex Female

Date of Birth January 25, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father George J. Lewis MAIDEN NAME of Mother Sadie Florence McKillop

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

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

Occupation of Father at Birth of child Fireman Place of birth of Father Glace Bay, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lauchlin Leslie Address of Applicant 164 Murphy Road, Westmount, Cape Breton Co., NS Date 10 September 1976

Relationship of Applicant to child Nil

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of MinervaLewis

Born at Sydney in the County of Cape Breton

That MinervaLewis Whose Birth is sought to be registered was

born at Sydney Cape Breton County on January 25, 1924

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

Enclosed certificate of Baptism

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