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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100271

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bessie CatherineMuise Sex Female

Date of Birth May 13, 1920 Place of Birth East ChebogueCounty of Yarmouth

Name of Father Fred Muise MAIDEN NAME of Mother Gertie Clairmont

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

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Bessie Pothier Address of Applicant RR#1 Arcadia Date 16 July 1984

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bessie CatherineMuise

Born at East Chebogue in the County of Yarmouth

That Bessie CatherineMuise Whose Birth is sought to be registered was

born at East Chebogue Yarmouth County on May 13, 1920

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

certificate of baptism

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