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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000773

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marie CarmellaGouthro Sex Female

Date of Birth May 20, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father John Seward Gouthro MAIDEN NAME of Mother Anne Chiasson

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

Residence of Father when child was born Glace Bay Present address of Father deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father French Vale

Race Name and present address of Physician in attendance at birth

Signature of Applicant Marie C. Hughes Address of Applicant 643 Bathurst Ave. Ottawa, Ontario Date September 22, 1978

Relationship of Applicant to child same nee Gouthro

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marie CarmellaGouthro

Born at Glace Bay in the County of Cape Breton

That Marie CarmellaGouthro Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 20, 1921

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

I am an older brother, born Aug 21, 1911, and well remember the birth of my sister.

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