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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000698

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary Pauline LilianLeBlanc Sex Female

Date of Birth July 25, 1921 Place of Birth AmherstCounty of Cumberland

Name of Father Frank Phillip LeBlanc MAIDEN NAME of Mother Leone Gaudet

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

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

Occupation of Father at Birth of child Boiler Maker Place of birth of Father Dorchester, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Pauline Lillian LeBlanc Marks Address of Applicant 11 Minto St. Amherst Date August 4, 1977

Relationship of Applicant to child Applicants Birth is to be registered

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary Pauline LilianLeBlanc

Born at Amherst in the County of Cumberland

That Mary Pauline LilianLeBlanc Whose Birth is sought to be registered was

born at Amherst Cumberland County on July 25, 1921

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

My Baptismal Certificate indicates that I was born on July 25th, 1921. I have always understood that to be my Birth Date and have observed July 25th as my birthday since that time.

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