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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100162

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of JamesCormier Sex Male

Date of Birth November 4, 1920 Place of Birth Belle LakeCounty of Inverness

Name of Father Joseph E. Cormier MAIDEN NAME of Mother Marie LeBlanc

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

Residence of Father when child was born Belle Lake Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Belle Lake

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lorraine Blaise Address of Applicant Dartmouth Date April 27, 1982

Relationship of Applicant to child niece

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of JamesCormier

Born at Belle Lake in the County of Inverness

That JamesCormier Whose Birth is sought to be registered was

born at Belle Lake Inverness County on November 4, 1920

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

Baptismal

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