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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000427

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Catherine CeciliaChiasson Sex Female

Date of Birth July 21, 1922 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Francis Chiasson MAIDEN NAME of Mother Mary Mombourquette

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

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

Occupation of Father at Birth of child Coal Miner Place of birth of Father Cheticamp, Inverness

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Catherine Nevins Address of Applicant 101 Eldomar Avenue, Brampton, Ontario Date August 1971

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Catherine CeciliaChiasson

Born at New Waterford in the County of Cape Breton

That Catherine CeciliaChiasson Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on July 21, 1922

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

I am the said Catherine Cecelia Chiasson and have examined my certificate of baptism giving the above particulars.

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