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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000142

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Damien PaulDeCoste Sex Male

Date of Birth August 17, 1921 Place of Birth Havre BoucherCounty of Antigonish

Name of Father Urban DeCoste MAIDEN NAME of Mother Mary Alice LeVangie

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

Residence of Father when child was born Havre Boucher Present address of Father Havre Boucher

Occupation of Father at Birth of child Carpenter Place of birth of Father Havre Boucher

Race French Name and present address of Physician in attendance at birth Dr. J.S. Brean

Signature of Applicant Mary Alice DeCoste Address of Applicant Havre Boucher Date October 4, 1951

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Damien PaulDeCoste

Born at Havre Boucher in the County of Antigonish

That Damien PaulDeCoste Whose Birth is sought to be registered was

born at Havre Boucher Antigonish County on August 17, 1921

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

I am the mother of Damien Paul DeCoste (Baptism Certificate)

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