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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000454

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Agnes CatherineLeBlanc Sex Female

Date of Birth September 15, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Gilbert LeBlanc MAIDEN NAME of Mother Ann Jane  MacIsaac

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

Residence of Father when child was born Bay Street. Sydney Present address of Father deceased

Occupation of Father at Birth of child Sydney Louisburg Railway Place of birth of Father Margaree

Race French Name and present address of Physician in attendance at birth Dr. A. Clader

Signature of Applicant Agnes Catherine LeBlanc Address of Applicant 444 Lumsden Ave. of the Borough of East York, Toronto, Ontario Date January 29, 1971

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Agnes CatherineLeBlanc

Born at Sydney in the County of Cape Breton

That Agnes CatherineLeBlanc Whose Birth is sought to be registered was

born at Sydney Cape Breton County on September 15, 1921

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

Enclosed is my Baptismal Certificate and proof of age etc.

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