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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000496

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen RitaCormier Sex Female

Date of Birth January 1, 1920 Place of Birth JogginsCounty of Cumberland

Name of Father Albert  Cormier MAIDEN NAME of Mother Kathleen Brine

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

Residence of Father when child was born Joggins Present address of Father Toronto, Ontario

Occupation of Father at Birth of child Miner Place of birth of Father Joggins

Race French Name and present address of Physician in attendance at birth Dr. Rockwell

Signature of Applicant Helen R. Address of Applicant Miller Date August 4, 1969

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen RitaCormier

Born at Joggins in the County of Cumberland

That Helen RitaCormier Whose Birth is sought to be registered was

born at Joggins Cumberland County on January 1, 1920

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

Information from parents. Baptism Certificate

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