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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000456

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Raymond VincentLevangie Sex Male

Date of Birth October 10, 1921 Place of Birth Havre BoucherCounty of Antigonish

Name of Father Edward Levangie MAIDEN NAME of Mother Margaret DeCoste

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

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

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

Race Canadian Name and present address of Physician in attendance at birth midwife

Signature of Applicant Raymond Vincent Levangie Address of Applicant 3994 Joyce Ave. Powell River, British Columbia Date March 4, 1971

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Raymond VincentLevangie

Born at Havre Boucher in the County of Antigonish

That Raymond VincentLevangie Whose Birth is sought to be registered was

born at Havre Boucher Antigonish County on October 10, 1921

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

Attached Certificate of Birth and Baptism dated July 15, 1957

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