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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200327

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Francis LavineCuvelier Sex Female

Date of Birth November 29, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Daniel Cuvelier MAIDEN NAME of Mother Annie Wamboldt

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

Residence of Father when child was born Halifax Present address of Father 264 Chebucto Rd.

Occupation of Father at Birth of child Teamster Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth Dr. Grace Rice

Signature of Applicant Annie Cuvelier Address of Applicant 264 Chebucto Rd. Date 02 December 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Francis LavineCuvelier

Born at Halifax in the County of Halifax

That Francis LavineCuvelier Whose Birth is sought to be registered was

born at Halifax Halifax County on November 29, 1919

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

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