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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000542

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth October 9, 1921 Place of Birth Reserve MinesCounty of Cape Breton

Name of Father William Gallant MAIDEN NAME of Mother Martha Young

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

Residence of Father when child was born Reserve Mines Present address of Father Reserve Mines

Occupation of Father at Birth of child Miner Place of birth of Father Reserve Mines

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

Signature of Applicant R.W. Gallant Address of Applicant 5 Hall St. Reserve Mines Date February 15, 1974

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Reserve Mines in the County of Cape Breton

That Raymond WilliamGallant Whose Birth is sought to be registered was

born at Reserve Mines Cape Breton County on October 9, 1921

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

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