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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000586

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lillian IreneStevens Sex Female

Date of Birth December 21, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Benjamin Stevens MAIDEN NAME of Mother Naomi Pitcher

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 Deceased

Occupation of Father at Birth of child Steel Worker Place of birth of Father Clarks Beach, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lillian Irene Stevens Address of Applicant RR #3, Sydney, Cape Breton Co., NS Date August 1978

Relationship of Applicant to child One and same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lillian IreneStevens

Born at Sydney in the County of Cape Breton

That Lillian IreneStevens Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 21, 1924

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

I am the said Lillian Irene Stevens

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