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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000028

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Cyril MarcelAncelet Sex Male

Date of Birth August 3, 1920 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Jules Fernand Ancelet MAIDEN NAME of Mother Filicie Lardinois

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

Residence of Father when child was born New Waterford Present address of Father Coleman, Alberta

Occupation of Father at Birth of child Coal Miner Place of birth of Father Guis, France

Race French Name and present address of Physician in attendance at birth Dr. Hartigan, New Waterford

Signature of Applicant Filicie Ancelet Address of Applicant Coleman, Alberta Date May 14, 1947

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Cyril MarcelAncelet

Born at New Waterford in the County of Cape Breton

That Cyril MarcelAncelet Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on August 3, 1920

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

That I am the mother of Cyril Marcel Ancelet

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