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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100263

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marie HeleneDoucet Sex Female

Date of Birth December 8, 1920 Place of Birth Saint Joseph du MoineCounty of Inverness

Name of Father Calixte Doucet MAIDEN NAME of Mother Louise Roche

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

Residence of Father when child was born St. Joseph du Moines Present address of Father Plateau

Occupation of Father at Birth of child fish shed worker Place of birth of Father Grand Etang, St Joseph du Moine

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Marie Helene Doucet Address of Applicant Port Colborne, ON Date 29 May 1984

Relationship of Applicant to child

AFFIDAVIT

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

Born at Saint Joseph du Moine in the County of Inverness

That Marie HeleneDoucet Whose Birth is sought to be registered was

born at Saint Joseph du Moine Inverness County on December 8, 1920

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

church birth certificate

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