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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700268

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anne-Marie LeonaMoulins Sex Female

Date of Birth November 9, 1919 Place of Birth SydneyCounty of Cape Breton

Name of Father Jean Gustave Moulins MAIDEN NAME of Mother Leona Emilie Marie Duhagon

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

Residence of Father when child was born Sydney Present address of Father 77 Ferry St.

Occupation of Father at Birth of child Steel worker Place of birth of Father Montmartin en Gregnes, France

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

Signature of Applicant Jean Gustave Moulins Address of Applicant 77 Ferry St., Sydney Date 24 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anne-Marie LeonaMoulins

Born at Sydney in the County of Cape Breton

That Anne-Marie LeonaMoulins Whose Birth is sought to be registered was

born at Sydney Cape Breton County on November 9, 1919

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

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