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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000554

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Paul IvanSaulnier Sex Male

Date of Birth April 21, 1921 Place of Birth BrooklynCounty of Yarmouth

Name of Father Joseph Saulnier MAIDEN NAME of Mother Helen Saulnier

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

Residence of Father when child was born Yarmouth Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Saulnierville

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

Signature of Applicant Paul Ivan Saulnier Address of Applicant Brooklyn Date July 5, 1974

Relationship of Applicant to child n/a

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Paul IvanSaulnier

Born at Brooklyn in the County of Yarmouth

That Paul IvanSaulnier Whose Birth is sought to be registered was

born at Brooklyn Yarmouth County on April 21, 1921

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

1) That I have previously delivered a Certificate of Birth and Baptism stating my date of birth as April 21, 1921 2) I have been advised by other members of my family that April 21/21 was my birth date

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