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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500117

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Earvill Robert JosephArsenault Sex Male

Date of Birth November 4, 1919 Place of Birth Joggins MinesCounty of Cumberland

Name of Father James Arsenault MAIDEN NAME of Mother Georgina Hache

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

Residence of Father when child was born Joggins Mines Present address of Father

Occupation of Father at Birth of child Carpenter Place of birth of Father Joggins Mines

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

Signature of Applicant Georgina Arsenault Address of Applicant Joggins Mines Date 29 December 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Earvill Robert JosephArsenault

Born at Joggins Mines in the County of Cumberland

That Earvill Robert JosephArsenault Whose Birth is sought to be registered was

born at Joggins Mines Cumberland County on November 4, 1919

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

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