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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000241

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John FrancisArsenault Sex Male

Date of Birth January 17, 1922 Place of Birth Alder PointCounty of Cape Breton

Name of Father Ephraim Arsenault MAIDEN NAME of Mother Della Lambert

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

Residence of Father when child was born Alder Point, Cape Breton Present address of Father Alder Point, Cape Breton

Occupation of Father at Birth of child Fisherman Place of birth of Father Alder Point, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant John Francis Arsenault Address of Applicant Atlantic Street, Sydney, Cape Breton Date 1 March 1959

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John FrancisArsenault

Born at Alder Point in the County of Cape Breton

That John FrancisArsenault Whose Birth is sought to be registered was

born at Alder Point Cape Breton County on January 17, 1922

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

Information from parents. Certificate from Church records herewith enclosed.

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