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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000626

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 27, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Thomas A. Lake MAIDEN NAME of Mother Rhoda Hillier

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

Residence of Father when child was born 44 St. Albans Avenue, Sydney, Cape Breton Co., NS Present address of Father 44 St. Albans Avenue, Sydney, Cape Breton Co., NS

Occupation of Father at Birth of child Steel Worker Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Vida Plumridge Address of Applicant 35 Warne Street, Sydney, Cape Breton Co., NS Date 5 April 1979

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That VidaLake Whose Birth is sought to be registered was

born at Sydney Cape Breton County on July 27, 1924

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

Dedication Certificate (Class A Evidence)

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