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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000133

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marie RitaBelliveau Sex Female

Date of Birth January 1, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Albert A. Belliveau MAIDEN NAME of Mother Lusie Gaudet

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

Residence of Father when child was born 52 Langard Rd. Halifax Present address of Father 30 2nd St. Norwich, Conneticut, USA

Occupation of Father at Birth of child Carpenter Place of birth of Father St. Joseph Westmorland County, NB

Race White Name and present address of Physician in attendance at birth Halifax

Signature of Applicant Mrs. Lusie Belliveau Address of Applicant 30 2nd St. Norwich, Conneticut, USA Date July 27, 1950

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marie RitaBelliveau

Born at Halifax in the County of Halifax

That Marie RitaBelliveau Whose Birth is sought to be registered was

born at Halifax Halifax County on January 1, 1920

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

Born at home (house owned by Richard McKenzie 834 Robie St. Halifax) Dr. Malkasey, nurse (district, name I don't remember my only Maximle LeBlanc's wife at the house with the Dr. - Sarah LeBlanc (Mrs. Annie E. McKenzie at 834 Robie St. Halifax can certified this birth) I am her mother - Church certificate attached

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