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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000315

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bernard EmileMuise Sex Male

Date of Birth July 20, 1921 Place of Birth QuinanCounty of Yarmouth

Name of Father Couis Muise MAIDEN NAME of Mother Helen LeBlanc

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

Residence of Father when child was born Quinan Present address of Father 30 Lynet Dr. Spryfrield

Occupation of Father at Birth of child Masonry Place of birth of Father Quinan

Race French Name and present address of Physician in attendance at birth

Signature of Applicant B.E. Muise Address of Applicant 5285 Morris St. Halifax Date May 7, 1963

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bernard EmileMuise

Born at Quinan in the County of Yarmouth

That Bernard EmileMuise Whose Birth is sought to be registered was

born at Quinan Yarmouth County on July 20, 1921

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

Baptism Certificate

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