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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500195

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Cyrus Gerald JosephLeBlanc Sex Male

Date of Birth December 30, 1919 Place of Birth AmherstCounty of Cumberland

Name of Father Severe LeBlanc MAIDEN NAME of Mother Lena LeBlanc

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

Residence of Father when child was born Amherst Present address of Father 15 1/2 Patterson St.

Occupation of Father at Birth of child Labourer Place of birth of Father Memramcook, NB

Race Name and present address of Physician in attendance at birth Dr. A.E. MacKintosh

Signature of Applicant Severe LeBlanc Address of Applicant 15 1/2 Patterson St. Date 10 January 1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Cyrus Gerald JosephLeBlanc

Born at Amherst in the County of Cumberland

That Cyrus Gerald JosephLeBlanc Whose Birth is sought to be registered was

born at Amherst Cumberland County on December 30, 1919

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

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