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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100337

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ralph Milton Dauphinee Sex Male

Date of Birth September 19, 1920 Place of Birth Glen HavenCounty of Halifax

Name of Father Percy Dauphinee MAIDEN NAME of Mother  Frederick

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

Residence of Father when child was born Glen Haven Present address of Father deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Glen Haven

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ralph Milton Dauphinee Address of Applicant Bedford Date April 3, 1985

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ralph Milton Dauphinee

Born at Glen Haven in the County of Halifax

That Ralph Milton Dauphinee Whose Birth is sought to be registered was

born at Glen Haven Halifax County on September 19, 1920

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

I have kept birthdays with one Mrs. Dadie Boutilier, of French Village, deceased, since I was a child as she and I have the same birthdate of September 19, and so long as I can remember all my life I have dated my age from that date in 1920, which was the birthdate my mother gave me when she was alive.

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