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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000844

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jacqueline Catherine Jeanne d'ArcThibault Sex Female

Date of Birth June 12, 1921 Place of Birth French VillageCounty of Halifax

Name of Father John Thibault MAIDEN NAME of Mother Dolores Carriere

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

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

Occupation of Father at Birth of child Station Agent C.N.R. Place of birth of Father Havelock

Race Name and present address of Physician in attendance at birth

Signature of Applicant E.J. Kilmury Address of Applicant Ottawa, Ontario Date August 1, 1979

Relationship of Applicant to child none

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jacqueline Catherine Jeanne d'ArcThibault

Born at French Village in the County of Halifax

That Jacqueline Catherine Jeanne d'ArcThibault Whose Birth is sought to be registered was

born at French Village Halifax County on June 12, 1921

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

Baptismal Certificate

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