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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000711

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of AnnieBinette Sex Female

Date of Birth May 21, 1922 Place of Birth L'ArdoiseCounty of Richmond

Name of Father James Binette MAIDEN NAME of Mother Julia Taylor

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

Residence of Father when child was born L'Ardoise, Richmond Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father L'Ardoise, Richmond

Race Name and present address of Physician in attendance at birth

Signature of Applicant Anne Belle Sampson Address of Applicant Cherry Street, Sydney, Cape Breton Date 3 November 1978

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of AnnieBinette

Born at L'Ardoise in the County of Richmond

That AnnieBinette Whose Birth is sought to be registered was

born at L'Ardoise Richmond County on May 21, 1922

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

Certificate of birth and baptism (attached)

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