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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000305

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James HerbertLeBlanc Sex Male

Date of Birth February 28, 1922 Place of Birth YarmouthCounty of Yarmouth

Name of Father Lawerence LeBlanc MAIDEN NAME of Mother Lena LeBlanc

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

Residence of Father when child was born Yarmouth Present address of Father

Occupation of Father at Birth of child General helper in garage Place of birth of Father Yarmouth

Race Name and present address of Physician in attendance at birth

Signature of Applicant James Herbert LeBlanc Address of Applicant Streetsville, Ontario Date 10 February 1964

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James HerbertLeBlanc

Born at Yarmouth in the County of Yarmouth

That James HerbertLeBlanc Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on February 28, 1922

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

Certificate of birth and baptism. St. Ambrose Cathedral, Yarmouth, dated 2 February 1963.

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