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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000778

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James JohnLeBlanc Sex Male

Date of Birth December 29, 1921 Place of Birth CheticampCounty of Inverness

Name of Father Charles  LeBlanc MAIDEN NAME of Mother Sophie Deveau

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

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

Occupation of Father at Birth of child Woodsman Place of birth of Father Cheticamp

Race Name and present address of Physician in attendance at birth

Signature of Applicant James J. LeBlanc Address of Applicant 51 Hankard St. Sydney Date November 18, 1978

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James JohnLeBlanc

Born at Cheticamp in the County of Inverness

That James JohnLeBlanc Whose Birth is sought to be registered was

born at Cheticamp Inverness County on December 29, 1921

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

This is my own birth.

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