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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000823

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Julia MayMombourquette Sex

Date of Birth August 25, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Frederick Mombourquette MAIDEN NAME of Mother Lucie Melanson

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

Residence of Father when child was born Halifax Present address of Father deceased

Occupation of Father at Birth of child Labourer Place of birth of Father L'Ardoise

Race Name and present address of Physician in attendance at birth

Signature of Applicant Julia M. Brown Address of Applicant 9 Syc(a)more Lane, Lower Sackville Date March 30, 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Julia MayMombourquette

Born at Halifax in the County of Halifax

That Julia MayMombourquette Whose Birth is sought to be registered was

born at Halifax Halifax County on August 25, 1920

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

Baptism Marriage Record

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