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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000292

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ellen Theresa LouiseCoffie Sex Female

Date of Birth November 29, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Benjamin Coffie MAIDEN NAME of Mother Clara McPhee

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

Residence of Father when child was born Sydney, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father St. Pierre & Miquelon

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Thomas Stables Address of Applicant 41 Linden Street, New London, Connecticut, USA Date January 1963

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ellen Theresa LouiseCoffie

Born at Sydney in the County of Cape Breton

That Ellen Theresa LouiseCoffie Whose Birth is sought to be registered was

born at Sydney Cape Breton County on November 29, 1922

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

Information received from my parents and from church baptism records.

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