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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000897

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dora AgnesGregoire Sex Female

Date of Birth July 30, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father John Gregoire MAIDEN NAME of Mother Eunice Bowes

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

Residence of Father when child was born Sable Island Present address of Father deceased

Occupation of Father at Birth of child Lighthouse Keeper Place of birth of Father Eastern Passage

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dora A. LeBaron Address of Applicant Dartmouth Date August 18, 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dora AgnesGregoire

Born at Halifax in the County of Halifax

That Dora AgnesGregoire Whose Birth is sought to be registered was

born at Halifax Halifax County on July 30, 1921

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

Baptism

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