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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700376

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Theresa BlanchArsenault Sex Female

Date of Birth November 4, 1919 Place of Birth Little Bras D'OrCounty of Cape Breton

Name of Father Joseph Arsenault MAIDEN NAME of Mother Mary Elizabeth King

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

Residence of Father when child was born Little Bras d'Or Present address of Father

Occupation of Father at Birth of child Coal miner Place of birth of Father Magdalene Islands

Race Name and present address of Physician in attendance at birth Dr. William T. McKeough

Signature of Applicant Joseph Arsenault Address of Applicant Little Bras d'Or Date 09 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Theresa BlanchArsenault

Born at Little Bras D'Or in the County of Cape Breton

That Theresa BlanchArsenault Whose Birth is sought to be registered was

born at Little Bras D'Or Cape Breton 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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