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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000913

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Joseph ErnestPoirier Sex Male

Date of Birth October 18, 1921 Place of Birth LouisdaleCounty of Richmond

Name of Father Collin Poirier MAIDEN NAME of Mother Mary Alma Landry

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

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

Occupation of Father at Birth of child Painter Place of birth of Father Martineque

Race Name and present address of Physician in attendance at birth

Signature of Applicant Joseph Ernest Poirier Address of Applicant Louisdale Date January 1981

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Joseph ErnestPoirier

Born at Louisdale in the County of Richmond

That Joseph ErnestPoirier Whose Birth is sought to be registered was

born at Louisdale Richmond County on October 18, 1921

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

Certificate of baptism. St. Louis Parish Church, Louisdale, Richmond County

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