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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000497

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frances Louise Mary PeterGodfroid Sex Female

Date of Birth August 28, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Peter Godfroid MAIDEN NAME of Mother Mary Gabriel Lambert

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

Residence of Father when child was born Sydney Present address of Father 22405 Kent Ave. Apt. 21, Torrence, California

Occupation of Father at Birth of child Electrician Place of birth of Father Belgium

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

Signature of Applicant Vincent P. Masr Address of Applicant 17277 Iyami, Strongville, Ohio Date May 25, 1972

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frances Louise Mary PeterGodfroid

Born at Sydney in the County of Cape Breton

That Frances Louise Mary PeterGodfroid Whose Birth is sought to be registered was

born at Sydney Cape Breton County on August 28, 1921

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

Presentation of Baptismal Record (enclosed) with sponsors Anthony Ducey and Christina Whelan Performed by Father James M. Kiely at Parish of the Holy Redeemer at Whitney Pier

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