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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000689

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy FrancesBellfontaine Sex Female

Date of Birth November 23, 1922 Place of Birth New GlasgowCounty of Pictou

Name of Father Alphonsus Bellfontaine MAIDEN NAME of Mother Susan Murphy

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

Residence of Father when child was born New Glasgow, Pictou Present address of Father Deceased

Occupation of Father at Birth of child Baker Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth

Signature of Applicant Walter LaPierre Address of Applicant 7 Parker Street, Dartmouth Date 7 June 1978

Relationship of Applicant to child None

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy FrancesBellfontaine

Born at New Glasgow in the County of Pictou

That Dorothy FrancesBellfontaine Whose Birth is sought to be registered was

born at New Glasgow Pictou County on November 23, 1922

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

Baptismal certificate

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