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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100061

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marie PrimaCormier Sex

Date of Birth February 29, 1920 Place of Birth AmherstCounty of Cumberland

Name of Father Blank  MAIDEN NAME of Mother Tina Cormier

Were the Parents married at the time of the Birth?

Residence of Father when child was born Present address of Father Blank

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant M. Prima Davison Address of Applicant R.R. #2, Trenton Date May 6, 1980

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Amherst in the County of Cumberland

That Marie PrimaCormier Whose Birth is sought to be registered was

born at Amherst Cumberland County on February 29, 1920

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

1. That I am an Aunt of the applicant. 2. That I clearly recall the date of birth. 3. That her birthday was always noted as being Feb. 29th, 1920.

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