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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000476

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Charles StephenLeBlanc Sex Male

Date of Birth August 16, 1921 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Peter LeBlanc MAIDEN NAME of Mother Lucy LeFort

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

Residence of Father when child was born New Waterford Present address of Father deceased

Occupation of Father at Birth of child Railway Labour Worker Place of birth of Father Margaree

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

Signature of Applicant Charles Stephen LeBlanc Address of Applicant 48 Victoria Ave. New Waterford Date October 18, 1971

Relationship of Applicant to child The same person as the applicant

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Charles StephenLeBlanc

Born at New Waterford in the County of Cape Breton

That Charles StephenLeBlanc Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on August 16, 1921

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

Entry # 1143 in the Baptismal Register of Mount Carmel Church

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