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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100136

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gerald JohnPothier Sex Male

Date of Birth September 23, 1920 Place of Birth WedgeportCounty of Yarmouth

Name of Father John Dennis Pothier MAIDEN NAME of Mother Rosie E. Muise

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

Residence of Father when child was born Wedgeport, Yarmouth Co. Present address of Father deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Wedgeport, Yarmouth Co.

Race Name and present address of Physician in attendance at birth

Signature of Applicant Gerald J. Pothier Address of Applicant RR #1, Arcadia, Yarmouth Co. Date 28 August 1981

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gerald JohnPothier

Born at Wedgeport in the County of Yarmouth

That Gerald JohnPothier Whose Birth is sought to be registered was

born at Wedgeport Yarmouth County on September 23, 1920

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

The actual baptism certificate

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