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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000951

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of May MargueriteDuyon Sex Female

Date of Birth September 3, 1920 Place of Birth MartiniqueCounty of Richmond

Name of Father Paul Duyon MAIDEN NAME of Mother Lizer Sampson

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

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

Occupation of Father at Birth of child Labourer Place of birth of Father Martinique

Race Name and present address of Physician in attendance at birth

Signature of Applicant Gordon Samson Address of Applicant Arichat Date January 23, 1979

Relationship of Applicant to child no relation - friend

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of May MargueriteDuyon

Born at Martinique in the County of Richmond

That May MargueriteDuyon Whose Birth is sought to be registered was

born at Martinique Richmond County on September 3, 1920

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

As described in attached Certificate of Baptismal

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