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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100202

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of David JohnLeBeau Sex Male

Date of Birth September 29, 1921 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Joseph LeBeau MAIDEN NAME of Mother Euphemia LeBeau

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

Residence of Father when child was born New Waterford Present address of Father deceased

Occupation of Father at Birth of child Place of birth of Father New Waterford

Race Name and present address of Physician in attendance at birth

Signature of Applicant R. Eisher Hudson Address of Applicant Baddeck Date January 1988

Relationship of Applicant to child none

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of David JohnLeBeau

Born at New Waterford in the County of Cape Breton

That David JohnLeBeau Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on September 29, 1921

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

Dedication Certificate

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