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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000139

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rita ElisabethPoirier Sex Female

Date of Birth November 21, 1921 Place of Birth Margaree ForksCounty of Cape Breton

Name of Father Honore Poirier MAIDEN NAME of Mother Louise Roach

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

Residence of Father when child was born Margaree Forks Present address of Father Margaree Forks

Occupation of Father at Birth of child Farmer Place of birth of Father Inverness

Race French Name and present address of Physician in attendance at birth Dr. Mose McGarry

Signature of Applicant Henry J. Chiasson Address of Applicant 36- 10th St. New Waterford Date May 9, 1951

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rita ElisabethPoirier

Born at Margaree Forks in the County of Cape Breton

That Rita ElisabethPoirier Whose Birth is sought to be registered was

born at Margaree Forks Cape Breton County on November 21, 1921

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

See attached Baptismal Record

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