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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000153

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Vernon JohnLorette Sex Male

Date of Birth January 10, 1921 Place of Birth River HebertCounty of Cumberland

Name of Father Roy Lorette MAIDEN NAME of Mother Florance McClelland

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

Residence of Father when child was born River Hebert Present address of Father River Hebert

Occupation of Father at Birth of child Miner Place of birth of Father Sackville, New Brunswick

Race Canadian Name and present address of Physician in attendance at birth Dr. Pickford

Signature of Applicant Flora E. Lorette Address of Applicant River Hebert Date May 23, 1951

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Vernon JohnLorette

Born at River Hebert in the County of Cumberland

That Vernon JohnLorette Whose Birth is sought to be registered was

born at River Hebert Cumberland County on January 10, 1921

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

I am the mother of the above named Vernon John Lorette (Baptism certificate)

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